Time pressured deprioritization of COPD in primary care: a qualitative study
2016 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 34, no 1, 55-65 p.Article in journal (Refereed) PublishedText
Objective: To identify factors that hinder discussions regarding chronic obstructive pulmonary disease (COPD) between primary care physicians (PCPs) and their patients in Sweden. Setting: Primary health care centres (PHCCs) in Stockholm, Sweden. Subjects: A total of 59 PCPs. Design: Semi-structured individual and focus-group interviews between 2012 and 2014. Data were analysed inspired by grounded theory methods (GTM). Results: Time-pressured patient-doctor consultations lead to deprioritization of COPD. During unscheduled visits, deprioritization resulted from focusing only on acute health concerns, while during routine care visits, COPD was deprioritized in multi-morbid patients. The reasons PCPs gave for deprioritizing COPD are: Not becoming aware of COPD, Not becoming concerned due to clinical features, Insufficient local routines for COPD care, Negative personal attitudes and views about COPD, Managing diagnoses one at a time, and Perceiving a patient's motivation as low''. Conclusions: De-prioritization of COPD was discovered during PCP consultations and several factors were identified associated with time constraints and multi-morbidity. A holistic consultation approach is suggested, plus extended consultation time for multi-morbid patients, and better documentation and local routines.
Place, publisher, year, edition, pages
2016. Vol. 34, no 1, 55-65 p.
Barriers, COPD, general practice, guideline, management, multi-morbidity, primary care, primary care physicians, qualitative study type, Sweden
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-283797DOI: 10.3109/02813432.2015.1132892ISI: 000372023200009PubMedID: 26849465OAI: oai:DiVA.org:uu-283797DiVA: diva2:921256