A partnership approach to COPD diagnosis and management in general practice?

S. Dennis, Sandy Middleton, H. K. Reddel, G. Marks, Oshana Hermiz, S. T. Hasan, S. Vagholkar, N. Zwar

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

Aim: To explore how general practitioners (GPs) and practice nurses (PNs) work in partnership to diagnose and manage COPD

Methods: Semi-structured interviews were conducted with a purposive sample of general practitioners and practice nurses who had taken part in a randomised controlled trial of GP-PN partnership for case-finding and management of patients with COPD, PELICAN study. The interviews were digitally recorded and transcribed verbatim. The transcripts were coded in NVivo 10 using the theoretical domains framework. The theoretical domains framework has been used in implementation science to understand health professional clinical behaviour change and uptake of evidence based practices and was used as a framework to guide the thematic analysis.

Results: When asked about their experience in the study the PNs talked about developing skills in spirometry and understanding the requirements for good quality spirometry. Several talked about their increased competence in spirometry and awareness of the requirements for good quality spirometry. However, many lacked confidence in its interpretation and felt that it was not part of their professional role, within their own practice, to interpret the results. This was also reflected in the responses from the GPs. Once COPD was diagnosed, the GPs tended to manage the patients and the PNs had less contact with the patient unlike their role in managing patients with other chronic diseases such as diabetes. The GPs valued the PNs' increased technical skills and competence in spirometry.

Conclusion: The PNs had improved their skills and confidence in spirometry by taking part in the study. Beliefs about professional role, identity and confidence impacted on the extent to which the PN was involved in interpretation of the results and care planning for the patient following diagnosis of COPD.
Original languageEnglish
Article numberTO 025
Pages (from-to)22
Number of pages1
JournalRespirology
Volume20
Issue numberSupplement 2
DOIs
Publication statusPublished - Mar 2015
Externally publishedYes
EventThoracic Society Australia New Zealand Australian New Zealand Society Respiratory Science Annual Scientific Meeting 2015 - Queensland, Australia
Duration: 27 Mar 20151 Apr 2015

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