Barriers to healthcare professionals encouraging self management in asthma and COPD

Younis, Izaba; Roberts, Nicola Jane; Partridge, Martyn

Abstract

Background: In general, non-implementation of guidelines reflects poor dissemination, healthcare professionals (HCPs) not believing recommendations, HCPs doubting their ability to deliver recommendations or HCPs making changes then resuming old habits.1 Only one or two studies have looked specifically at HCPs’ views regarding self-management (SM) in asthma or chronic obstructive pulmonary disease (COPD).

Methods: A questionnaire of HCPs’ views about SM plans in asthma and COPD was sent to respiratory SpRs and consultants in North London and a GP+nurse in 31 GP practices in one PCT. This abstract summarises the qualitative results.

Results: Responses were received from 54/176 questionnaires (18/55 GP; 13/41 nurse; 13/63 SPR 10/17 consultants). The results (number of comments from each section shown in brackets) show that HCPs recognise that SM strongly empowers patients and puts them in control of their own condition. HCPs also reported that SM improves outcomes and need for unscheduled health care (asthma,17; COPD, 43) and is likely to enhance compliance (asthma, 5; COPD, 4). HCPs perceive major barriers to patients receiving such advice are patient factors (asthma, 14; COPD, 20) such as literacy, cognition, intelligence and language barriers. Lack of time (asthma, 27; COPD, 20) and cooperation between primary and secondary care (asthma,11; COPD, 12) were highlighted. In a small number of cases, patients’ disinclination (asthma, 8; COPD, 2) is thought to be a factor and some HCPs (asthma, 6; COPD, 4) felt some patients were well controlled and did not need such advice. Final barriers represent lack of availability of material/templates upon which to write personalised action plans (asthma, 6; COPD, 12) or of honest reporting of a lack of HCP knowledge as to what such advice should consist of (asthma, 4; COPD, 4).

Conclusions: Qualitative analysis of HCPs’ views regarding SM in asthma and COPD suggests strong support for recommendations contained within guidelines and good understanding of the mechanisms by which improved outcomes are obtained. However, HCPs perceive characteristics which are likely to hinder this process, and yet many of these are unproven and, for many (such as impaired literacy), others have clearly shown solutions which permit implementation. In some cases HCPs candidly report lack of training in delivering these processes.

• Presentation Conference Type: Conference Abstract
• Conference Name: British Thoracic Society winter meeting
• Online Publication Date: Dec 1, 2009
• Publication Date: 2009-12
• Deposit Date: Aug 3, 2023
• Print ISSN: 0040-6376
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: Suppl 4
• Pages: A90
• Publisher URL: https://thorax.bmj.com/content/64/Suppl_4/A90