Conditions for COPD management in municipal healthcare – healthcare professionals’ perspective. A qualitative study

Abstract

Background: Access to recommended evidence-based interventions for people with chronic obstructive pulmonary disease (COPD) is low in primary and secondary care in Sweden. However, knowledge is missing on the conditions in Swedish municipal healthcare, where the oldest and most complex individuals are enrolled.

Aim: The aim of this study is to, from the perspective of healthcare professionals in municipal healthcare, explore the conditions for evidence-based interventions for people with COPD.

Methods: Healthcare professionals (n=36) in three municipalities in northern Sweden were interviewed. The interviews were analysed using qualitative content analysis, with triangulation among authors.

Results: The analysis resulted in the overarching theme Groping in the dark for adequate COPD management. This represents participants’ experiences of working with a somewhat disregarded diagnosis with insufficient conditions in municipal healthcare, which was falling behind the county council. The groping in the dark is further represented by the participants’ own lacking COPD-related competence and collaboration. The frail group of people with COPD and their relatives were considered in need of support adapted to their context, but routines and resources for COPD management were lacking.

Conclusions: The conditions for evidence-based interventions for people with COPD in municipal healthcare had several limitations, leading to insufficient management by healthcare professionals. To facilitate evidence-based interventions, there is a need to increase competence among healthcare professionals in municipal healthcare. In addition, several organisational barriers need to be addressed.