RT Journal Article
SR Electronic
T1 Internet-based self-management (IBSM) in asthma, from evidence to practice: A qualitative study of barriers and facilitators for implementation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3214
VO 38
IS Suppl 55
A1 Johanna L. van Gaalen
A1 Jiska B. Snoeck-Stroband
A1 Leti Vos
A1 Moira J. Bakker
A1 Ad A. Kaptein
A1 W.J.J. Assendelft
A1 Luuk N.A. Willems
A1 Bart P.A. Thoonen
A1 Jacob K. Sont
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/3214.abstract
AB Background: Internet-Based Self-Management (IBSM) support cost-effectively improves asthma control, asthma related quality of life, number of symptom-free days and lung function in patients with mild to moderate persistent asthma [Van der Meer 2009]. The current challenge is to implement IBSM.Aim: To assess relevant barriers and facilitators for implementing IBSM in current clinical practice.Methods: We conducted focus groups (FG) and interviews (for those not being able to participate in focus groups) based on a theoretical model. 20 patients (PT), 17 general practitioners (GP) and 8 practice nurses (PN) participated in FGs. In each FG an average of four persons participated. PTs (18-50 yr) had mild to moderate persistent asthma (>3 months ICS in the past year). Interviews were conducted with 2 PTs, 5 PNs and 4 GPs. FGs and interviews were audio-taped, fully transcribed and coded independently, using an existing framework of barriers [Grol 2004].Results: Main barriers at patient level: unawareness of the level of asthma control, asthma was not perceived as a chronic condition, PTs experienced difficulty of integrating self-management activities into daily life. Main barriers at professional/organisational level: unawareness of the level of asthma control, lack of structure of asthma care, lack of time and a lack of integration of IBSM in the GP electronic information system.Conclusion: Our findings indicate that future implementation strategies for IBSM need to address relevant barriers at professional/organisational and patient level, i.e. assessment of the level of asthma control and integration within daily practice.