Freya Davies1, Mette Bech Risør2, Hasse Melbye2, Mark Spigt3, Lucy Brookes-Howell4, Claire O'Neill4, Maciek Godycki-Cwirko5, Anja Wollny6, Elena Andreeva7, Chris Butler8, Nick Francis9. 1. Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK. Electronic address: DaviesF9@cf.ac.uk. 2. General Practice Research Unit, UiT, The Arctic University of Norway, Tromsø, Norway. 3. Department of Family Medicine, Maastricht University, Maastricht, Netherlands. 4. South East Wales Trials Unit, Cardiff University, Cardiff, UK. 5. Department of Family and Community Medicine, Medical University of Lodz, Lodz, Poland. 6. Department of General Practice, University Medical Centre, Rostock, Germany. 7. Department of Family Medicine, Northern State Medical University, Arkhangelsk, Russia. 8. Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK; Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. 9. Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK.
Abstract
OBJECTIVE: To explore clinicians' views on antibiotic and/or steroid 'rescue packs' used as self-treatment for patients with exacerbations of COPD. METHODS: 21 focus groups conducted in 7 countries--Netherlands, Russia, Norway, China (Hong Kong), Wales, Germany and Poland involving 142 primary care clinicians and pulmonologists. RESULTS: We found wide variation in reported use of and attitudes to self-treatment among GPs and pulmonologists in the participating countries. Clinicians highlighted the importance of identifying patients who were most likely to benefit (those with more severe disease) and most likely to use the treatment appropriately (demonstrated by previous behaviour), and the importance of adequate patient education and ongoing communication in regard to use of self-treatment packs. Clinicians recognised patient empowerment and facilitating prompt treatment as potential benefits of self-treatment. However, many felt they did not have the time or resources for appropriate patient selection and education. CONCLUSION: Clinicians do not feel it is appropriate to offer self-treatment rescue packs to all patients routinely without careful consideration of patient understanding of their illness and their capacity for self-management. PRACTICE IMPLICATIONS: Adequate resources and continuity of patient care are required for clinicians to feel confident in the safe and effective implementation of this strategy.
OBJECTIVE: To explore clinicians' views on antibiotic and/or steroid 'rescue packs' used as self-treatment for patients with exacerbations of COPD. METHODS: 21 focus groups conducted in 7 countries--Netherlands, Russia, Norway, China (Hong Kong), Wales, Germany and Poland involving 142 primary care clinicians and pulmonologists. RESULTS: We found wide variation in reported use of and attitudes to self-treatment among GPs and pulmonologists in the participating countries. Clinicians highlighted the importance of identifying patients who were most likely to benefit (those with more severe disease) and most likely to use the treatment appropriately (demonstrated by previous behaviour), and the importance of adequate patient education and ongoing communication in regard to use of self-treatment packs. Clinicians recognised patient empowerment and facilitating prompt treatment as potential benefits of self-treatment. However, many felt they did not have the time or resources for appropriate patient selection and education. CONCLUSION: Clinicians do not feel it is appropriate to offer self-treatment rescue packs to all patients routinely without careful consideration of patient understanding of their illness and their capacity for self-management. PRACTICE IMPLICATIONS: Adequate resources and continuity of patient care are required for clinicians to feel confident in the safe and effective implementation of this strategy.
Authors: Nick A Francis; David Gillespie; Patrick White; Janine Bates; Rachel Lowe; Bernadette Sewell; Rhiannon Phillips; Helen Stanton; Nigel Kirby; Mandy Wootton; Emma Thomas-Jones; Kerenza Hood; Carl Llor; Jochen Cals; Hasse Melbye; Gurudutt Naik; Micaela Gal; Deborah Fitzsimmons; Mohammed Fasihul Alam; Evgenia Riga; Ann Cochrane; Christopher C Butler Journal: Health Technol Assess Date: 2020-03 Impact factor: 4.014
Authors: Johanna Laue; Hasse Melbye; Peder A Halvorsen; Elena A Andreeva; Maciek Godycki-Cwirko; Anja Wollny; Nick A Francis; Mark Spigt; Kenny Kung; Mette Bech Risør Journal: Int J Chron Obstruct Pulmon Dis Date: 2016-12-08
Authors: Eva Anne Marije van Eerd; Mette Bech Risør; Mark Spigt; Maciek Godycki-Cwirko; Elena Andreeva; Nick Francis; Anja Wollny; Hasse Melbye; Onno van Schayck; Daniel Kotz Journal: NPJ Prim Care Respir Med Date: 2017-06-23 Impact factor: 2.871