Patients’ perspectives on the impact of a new COPD diagnosis in the face of multimorbidity: a qualitative study

Abstract

Background:Chronic obstructive pulmonary disease (COPD), a major cause of morbidity and mortality worldwide, often occurs in the presence of comorbidities, which may influence experience and management of the disease. No prior research seems to have gained perspectives of newly diagnosed primary care COPD patients in the context of multimorbidity.Aims:This qualitative study aimed to explore the impact of a new diagnosis of COPD in the context of multimorbidity and also sought to gain a better understanding of how patients react to the diagnosis and incorporate it into their lives.Methods:Participants were identified from a cohort of primary care patients with multimorbidity recently diagnosed with COPD. Data was collected via semi-structured interviews from nine male and eight female participants. Thematic analysis was performed and the data interpreted from a constructivist perspective.Results:Five core themes regarding COPD were induced: (i) reaction to diagnosis, (ii) impact on function and health behaviour, (iii) factors influencing self-management capacity, (iv) healthcare utilisation and (v) interplay of comorbidities. Most participants had difficulty recognising the importance of COPD and its long-term implications. For many, the salience of another chronic condition outweighed COPD. Self-management capacity and utilisation of healthcare services were challenged by low prioritisation of COPD among other comorbidities.Conclusions:This study provides an insight into how primary care patients feel about being diagnosed with COPD, as well as their prioritisation of the disease in the context of multimorbidity. It highlights the need for tailored education and personalised management incorporating patients’ perspectives in primary care.

Patients and families realising their future with chronic obstructive pulmonary disease—A qualitative study

“…The number of studies of the experience of COPD in its initial stages is growing (Ansari et al., ; Arne et al., ; Berger et al., ; Lindgren, Storli, & Wiklund‐Gustin, ; Lindqvist & Hallberg, ). Although patients in this study were younger than participants in most of the earlier studies, the findings are in harmony with what has previously been revealed.…”

“…Some may feel as they are less worthy of help because the disease is considered selfinflicted (Berger et al, 2011). Others might not recognise the seriousness of COPD (Ansari, Hosseinzadeh, Dennis, & Zwar, 2014).…”

General practitioners’ perceptions of COPD treatment: thematic analysis of qualitative interviews

“…Regarding information part, one study finds that the patients have “expert” knowledge, and that they know what to do in the case of exacerbations 22. Other studies, however, show that the patients do want more information about COPD early in the process, preferably at the time of diagnosis,23 and that patients with moderate COPD lack knowledge of the disease 14,24–26. Because COPD is a progressive disease, the need for information and behavior change counseling can vary over time.…”

Multimorbidity and COPD Medication Receipt Among Medicaid Beneficiaries With Newly Diagnosed COPD

“…A recently conducted qualitative study in Australia that examined the "patients' perspectives on the impact of a new COPD diagnosis in the face of multimorbidity" indicated that subjects with existing chronic conditions ascribed low importance to the management of a new COPD diagnosis. 37 Moreover, subjects with COPD and multimorbidity were challenged by multiple-medication use and thus had poor COPD self-management capacity. Although this study was conducted in Australia and had a limited sample size, it provides an important understanding of the relationship between multimorbidity and COPD medication receipt.…”