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Key words:?severe COPD, QVA149, lung function. Grant Support:?This study was sponsored by Novartis Pharmaceuticals AG. Table: Treatment differences in lung function. Parameter, L Treatment differences (least squares mean?��?standard error) QVA149 vs. glycopyrronium QVA149 vs. tiotropium p? Medicine at Repatriation [http://www.selleckchem.com/products/isrib-trans-isomer.html ISRIB] General Hospital, 2Department of Respiratory Medicine at Flinders Medical Centre & Repatriation General Hospital, 3Professor in Respiratory Medicine, Flinders University Respiratory Physician, Repatriation General Hospital Medical Director, Respiratory Laboratories Southern Adelaide Local Health Network, 4Adelaide Institute for Sleep Health (AISH), Repatriation General Hospital, Flinders University, 5Department of Respiratory Medicine, Repatriation General Hospital Aim:?To determine the main barriers for setting up pulmonary rehabilitation (PR) programmes in Saudi Arabia. Method:?A cross-sectional study was conducted in the eastern province in Saudi Arabia. Health care providers involved in treatment of COPD patients were recruited from 22 general government hospitals in this region. Data were collected using questionnaires. Results:?Only 4% of the recruited health care providers (physicians (n?=?44), nurses (n?=?49), and respiratory therapists/technicians (n?=?30); n?=?123) had heard of PR programmes. According [http://en.wikipedia.org/wiki/PSCD4 CYTH4] to the health care providers, [http://www.selleckchem.com/products/Metformin-hydrochloride(Glucophage).html Metformin in vitro] the main barriers for setting up PR programmes in the eastern province in Saudi Arabia were; lack of trained health care providers (72.4%), lack of hospital capacity (56.9%) and lack of funds (48%). There was a significant difference in barriers reported by different groups of health care providers, with nurses more likely to nominate that PR is an expensive approach (38.8%) compared to physicians (18%; P?