Unmet Healthcare Needs in COPD: A Text Network Analysis and Topic Modeling of Pre/Post-COVID-19 Research Trends.

Abstract

<b>Background/Objectives:</b> Unmet healthcare needs, driven by structural and patient-level barriers, are particularly critical in chronic obstructive pulmonary disease (COPD). However, limited research has examined how academic themes on this topic connect and evolve over time. This study analyzed the structure and temporal shifts in research trends on unmet healthcare needs in COPD to identify key concepts and topics and policy implications. <b>Methods:</b> We systematically searched PubMed, Embase, and CINAHL (12-15 March 2025) to identify English-language abstracts on unmet healthcare needs in COPD. Eligible studies were peer-reviewed articles with an English-language abstract that examined unmet healthcare needs from the patient perspective. In total, 451 abstracts were analyzed using text network analysis and Latent Dirichlet Allocation. Topic distributions before and after the coronavirus disease pandemic were assessed using chi-square tests, and findings were interpreted within Penchansky and Thomas's 5A healthcare access framework. <b>Results:</b> Six topics emerged: socioeconomic disparities, early diagnosis and symptom management, guideline-based information and technology use, integrated care for advanced COPD, access to pulmonary rehabilitation, and equitable medication availability. These topics mapped onto all five access dimensions, underscoring the multidimensional nature of unmet healthcare needs. Network analysis identified management, diagnosis, symptoms, exacerbation, and other related terms as central hubs in the discourse. Post-pandemic, research shifted toward digital information delivery, technology adoption, and equitable pharmacotherapy. <b>Conclusions:</b> Findings suggest that reducing unmet healthcare needs in COPD requires integrated systems that address both disease complexity and access barriers. Targeted, multidisciplinary, and policy-driven interventions in highly central domains are needed to reduce disparities and improve outcomes. This study also confirmed a post-pandemic shift in research priorities, emphasizing the need for equitable and adaptive healthcare policies.