Qualitative study of views of health professionals and patients on guided self management plans for asthma

Abstract

Objectives To explore the views held by general practitioners, practice nurses, and patients about the role of guided self management plans in asthma care.

An exploratory, pragmatic, cluster randomised trial of practice nurse training in the use of asthma action plans

“…7,8 Reported barriers include lack of confidence in the use of AAPs, and healthcare professionals believing that AAPs should be used only with certain types of patients. 9,10 Another possible reason for the 312 paucity of AAP use is that primary healthcare professionals are not convinced of the applicability of AAPs to their patients, 11,12 since the recommendation of AAP effectiveness is based on the outcome of randomised controlled trials (RCTs) 13 and not from "real-life" populations where most patients would not qualify for enrolment in a classic RCT. 14 Moreover, the frequent clinical care and monitoring of patients in RCTs is not typical of 'real-world' clinical situations.…”

Clinical allergy has much to gain from engagement with qualitative research

“…This situation is lamentable. In most other long-term conditions, qualitative research is now accepted as making a significant contribution to knowledge of effective management (16,17). Clinicians have a wealth of anecdotal evidence about patient experiences upon which to draw in their practice, but this is no substitute for systematic, in-depth qualitative enquiry.…”

Asthma action plans: use it or lose it

“…When asked [7], they said there were considerable barriers in the current practice structure to implementing these plans. Some aspects of the health care system no doubt could be modified to facilitate this process.…”

“…Some of these patients were getting verbal advice about how to change treatment but it was not systematised in the form of an adherence aiding device such as a written action plan. There are other studies that also give insight into what patient's think about written action plans [6,7]. A consistent message is that they need to be individualised to the patient's situation, and unless this happens the patient is likely to reject the plan [6].…”

“…GPs have questioned the place of action plans in promoting 'dependency' among patients or diminishing their patients autonomy [7]. When you ask patients about this they have differing views [9].…”