Poor communication may impair optimal asthma care: a qualitative study

Area of Science:

• General Practice
• Primary Care
• Respiratory Medicine
• Health Professions Education

Background:

• Asthma management is primarily conducted in general practice and primary care settings.
• Limited research exists on factors impacting the management of poorly controlled asthma in primary care.
• Understanding health care professional (HCP) perspectives on asthma management tools is crucial.

Purpose of the Study:

• To explore health care professionals' (HCPs) views on asthma guidelines and self-management plans (SMPs).
• To identify barriers to the routine use of asthma guidelines and SMPs in general practice.
• To understand why these tools are not consistently implemented in primary care settings.

Main Methods:

• Qualitative interviews and focus groups were conducted with 54 HCPs (GPs and practice nurses) in north-east Scotland.
• Explored participant experiences and attitudes towards asthma guidelines and SMPs.
• Investigated perceived barriers to guideline and SMP utilization.

Main Results:

• HCPs generally held positive views towards asthma guidelines and SMPs, but usage was conditional on perceived suitability.
• Suitability was influenced by patient-specific factors (e.g., psychosocial issues, asthma control) and professional factors (e.g., ease of use, time, role).
• HCPs reported a lack of communication skills, particularly for non-medical patient issues, and identified professional/organizational factors (training, communication) as impediments to effective asthma management.

Conclusions:

• Asthma guidelines provide the rationale ('why') but lack practical 'how-to' guidance for self-management.
• Poor professional-patient communication is a significant barrier to the uptake of SMPs and guideline use in primary care.
• There is a need for targeted training in communication skills to foster professional-patient partnerships for adult asthma management.