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Barriers to the implementation of self management support in long term lung conditions

Roberts, N. J.; Younis, I.; Kidd, L.; Partridge, M. R.


I. Younis

L. Kidd

M. R. Partridge


Background: Self-management improves outcomes in asthma and COPD and is strongly recommended in national and international guidelines; however implementation of the guidelines such as use of written action plans in practice is often poor.

Setting: A questionnaire survey was undertaken to identify the healthcare professional barriers to im-plementation of self-management for asthma and COPD in West London.

Question: Why is self-management education not being undertaken in respiratory conditions?

Methods: A questionnaire was designed to elicit healthcare professionals’ views about barriers to implementation of self-management in asthma and COPD.

Results: Response rates were 33% (58/175). Results showed strong support for guideline recommenda-tions, however implementation was patchy. Seventy six percent of respondents discussed asthma self-management with patients; however only 47.8% of patients received a written action plan. For COPD patients, 55.1% discussed self-management, with 41% receiving a written action plan. In COPD, there was greater GP involvement and less delegation of self-management. Barriers to implementation in-cluded patient factors (compliance, literacy and patient understanding), time constraints and in-sufficient resources. Those who believed they had witnessed improved health outcomes with self-management (53%, 31/58) were more likely to give written action plans (78%, 24/31, ‘nearly always/ sometimes’ gave written action plans), Nearly a third of healthcare professionals reported lacking confidence in constructing written action plans (33% 19/58; GPs 43%, nurses 43%).

Conclusion: Despite overwhelming evidence self-management support is still not being implemented into routine clinical practice, identified barriers included time constraints, lack of training, lack of belief in patients ability to self-manage and lack of confidence completing self-management plans.

Practice implications: These issues need to be addressed if self-management support is to be delivered in a meaningful and effective way.


Roberts, N. J., Younis, I., Kidd, L., & Partridge, M. R. (2013). Barriers to the implementation of self management support in long term lung conditions. London Journal of Primary Care, 5(1), 35-47.

Journal Article Type Article
Acceptance Date Feb 8, 2013
Online Publication Date Oct 7, 2015
Publication Date Apr 7, 2013
Deposit Date Aug 30, 2022
Journal London Journal of Primary Care
Print ISSN 1757-1472
Electronic ISSN 1757-1480
Publisher Taylor & Francis
Peer Reviewed Peer Reviewed
Volume 5
Issue 1
Pages 35-47
Keywords asthma, COPD, consultation, self-management
Public URL