General practice management of COPD patients following acute exacerbations: a qualitative study

Abstract

Background: Exacerbations are the strongest risk factor for future exacerbations for patients living with chronic obstructive pulmonary disease (COPD). The period immediately following exacerbation is a high-risk period for recurrence and hospital admission and is a critical time to intervene. General practitioners (GPs) are ideally positioned to deliver this care. Aim: To explore perceptions of GPs regarding the care of patients following exacerbations of COPD and to identify factors affecting the provision of evidence-based care. Design and setting: A descriptive qualitative study was undertaken involving semi-structured in-depth interviews with Australian GPs who volunteered to participate following a national survey of general practice care for COPD patients following exacerbations. Method: Interviews were conducted via Zoom video conference platform, audio recorded and transcribed verbatim. QSR NVivo was used to support data management, coding, and inductive thematic analysis. Results: Eighteen GPs completed interviews. Six key themes were identified: (1) GPs’ perceptions and knowledge in the management of COPD patients following exacerbation and hospitalisation; (2) Consultation time; (3) Pharmacological management; (4) Communication between healthcare professionals and (5) Access to other health services; (6) Patient compliance. Conclusion: Delivery of post-exacerbation care to COPD patients is affected by GPs, patients, and health servicerelated factors. The care of COPD patients may be further improved by supporting GPs to overcome identified barriers.