Abstract
Rationale: Pulmonary rehabilitation (PR) plays an important role in the chronic disease management of patient with COPD. Research shows that in primary care such multidisciplinary integrated programs has a positive effect on quality of life. However, the implementation of such integrated care pathways are dependent of the particular health care system. The goal of this qualitative research is to describe the usual care and current treatment of COPD patients in primary healthcare with a focus on PR, communication and collaboration among different healthcare workers.
Methods: Semi-structured interviews were performed according to to a pre-established script with a purposeful sample of 30 general practitioners whose office is located in the province Antwerp. All interviews were audio-taped, transcribed and analysed following the principles of thematic analysis.
Results: Assessment of the patients is primarily based on symptoms and functional status in their daily live with focus on quality of live. Although their well educated in spirometry, the GP not manage to perform these test due to organisational problems. Treatment is mainly focussed on pharmacotherapy, and pulmonary rehabilitation is hardly mentioned by the GP and not applied in their management. Interproffesional communication is limited to GP-pneumologist (re)-referral.
Conclusion: The management and treatment of COPD in primary care is mainly based on the functional status of the patient and pharmacological treatment according to evidence based guidelines. Integrated care including non-pharmacological management is not well implemented because of obstacles in interprofessional collaboration and practice management.
- Copyright ©the authors 2016
