Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study

Glenn Leemans,1 Dirk Vissers,1 Kris Ides,2– 4 Paul Van Royen5 1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; 2Cosys-Lab, Flanders Make, University of Antwerp, Antwerp, Belgium; 3Laboratory of Experimental Me...

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Main Authors: Leemans G, Vissers D, Ides K, Van Royen P
Format: Article
Language:English
Published: Dove Medical Press 2023-09-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/perspectives-and-attitudes-of-general-practitioners-towards-pharmacolo-peer-reviewed-fulltext-article-COPD
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author Leemans G
Vissers D
Ides K
Van Royen P
author_facet Leemans G
Vissers D
Ides K
Van Royen P
author_sort Leemans G
collection DOAJ
description Glenn Leemans,1 Dirk Vissers,1 Kris Ides,2– 4 Paul Van Royen5 1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; 2Cosys-Lab, Flanders Make, University of Antwerp, Antwerp, Belgium; 3Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; 4Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium; 5Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, BelgiumCorrespondence: Glenn Leemans, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium, Tel +32 495 34 84 59, Email glenn.leemans@student.uantwerpen.beBackground: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition that requires multidisciplinary management. In Belgium, the treatment of COPD is mainly managed by general practitioners (GPs). Several clinical practice guidelines (CPGs) recommend the use of non-pharmacological treatments, such as pulmonary rehabilitation, and interdisciplinary care for COPD patients. Although considerable research has been devoted to addressing the multitude of reasons for the lack of adherence to these aspects of the CPGs, less attention has been paid to understanding the perspectives and attitudes of GPs that lead to this suboptimal implementation.Purpose: This study aimed to 1) explore Belgian GPs’ perceptions regarding COPD management in a primary care setting and 2) collect their views on the importance of pulmonary rehabilitation and interprofessional care in COPD management.Methods: A descriptive study, conducted between August 2014 and May 2015, used interviews from a sample of 30 Flemish GPs. Data were analyzed following the principles of thematic analysis.Results: COPD management was patient-centered, focusing on immediate symptom relief and reducing future risks through pharmacotherapy and proper patient education. Deviations from the CPGs were noted, with only a few GPs performing spirometry themselves. Conditions to prescribe respiratory physiotherapy were not well known. Some GPs remained unconvinced about the (cost-)effectiveness of respiratory physiotherapy despite the fast-expanding scientific evidence. Interprofessional care was limited to GP-respiratory physician (re)-referral and communication. GPs showed a reactive attitude towards interprofessional collaboration for non-pharmacological therapies, which is not in line with the proactive approach recommended in CPGs.Conclusion: GPs managed COPD patients mainly by reducing symptoms with pharmacological therapy. Integrated care regarding non-pharmacological treatments was not well implemented due to the obstacles in interprofessional collaboration. Future care models incorporating personalized care planning could provide a solution to manage COPD’s complex healthcare demands.Keywords: asthma/COPD management, family medicine, non-pharmacologic treatment, pulmonary rehabilitation, interdisciplinary care, thematic analysis
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spelling doaj.art-4b59a6795eac4efc84f7c375b5b422de2023-09-26T18:27:38ZengDove Medical PressInternational Journal of COPD1178-20052023-09-01Volume 182105211586946Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative StudyLeemans GVissers DIdes KVan Royen PGlenn Leemans,1 Dirk Vissers,1 Kris Ides,2– 4 Paul Van Royen5 1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; 2Cosys-Lab, Flanders Make, University of Antwerp, Antwerp, Belgium; 3Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; 4Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium; 5Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, BelgiumCorrespondence: Glenn Leemans, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium, Tel +32 495 34 84 59, Email glenn.leemans@student.uantwerpen.beBackground: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition that requires multidisciplinary management. In Belgium, the treatment of COPD is mainly managed by general practitioners (GPs). Several clinical practice guidelines (CPGs) recommend the use of non-pharmacological treatments, such as pulmonary rehabilitation, and interdisciplinary care for COPD patients. Although considerable research has been devoted to addressing the multitude of reasons for the lack of adherence to these aspects of the CPGs, less attention has been paid to understanding the perspectives and attitudes of GPs that lead to this suboptimal implementation.Purpose: This study aimed to 1) explore Belgian GPs’ perceptions regarding COPD management in a primary care setting and 2) collect their views on the importance of pulmonary rehabilitation and interprofessional care in COPD management.Methods: A descriptive study, conducted between August 2014 and May 2015, used interviews from a sample of 30 Flemish GPs. Data were analyzed following the principles of thematic analysis.Results: COPD management was patient-centered, focusing on immediate symptom relief and reducing future risks through pharmacotherapy and proper patient education. Deviations from the CPGs were noted, with only a few GPs performing spirometry themselves. Conditions to prescribe respiratory physiotherapy were not well known. Some GPs remained unconvinced about the (cost-)effectiveness of respiratory physiotherapy despite the fast-expanding scientific evidence. Interprofessional care was limited to GP-respiratory physician (re)-referral and communication. GPs showed a reactive attitude towards interprofessional collaboration for non-pharmacological therapies, which is not in line with the proactive approach recommended in CPGs.Conclusion: GPs managed COPD patients mainly by reducing symptoms with pharmacological therapy. Integrated care regarding non-pharmacological treatments was not well implemented due to the obstacles in interprofessional collaboration. Future care models incorporating personalized care planning could provide a solution to manage COPD’s complex healthcare demands.Keywords: asthma/COPD management, family medicine, non-pharmacologic treatment, pulmonary rehabilitation, interdisciplinary care, thematic analysishttps://www.dovepress.com/perspectives-and-attitudes-of-general-practitioners-towards-pharmacolo-peer-reviewed-fulltext-article-COPDasthma/copd managementfamily medicinenon-pharmacologic treatmentpulmonary rehabilitationinterdisciplinary carethematic analysis
spellingShingle Leemans G
Vissers D
Ides K
Van Royen P
Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study
International Journal of COPD
asthma/copd management
family medicine
non-pharmacologic treatment
pulmonary rehabilitation
interdisciplinary care
thematic analysis
title Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study
title_full Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study
title_fullStr Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study
title_full_unstemmed Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study
title_short Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study
title_sort perspectives and attitudes of general practitioners towards pharmacological and non pharmacological copd management in a belgian primary care setting a qualitative study
topic asthma/copd management
family medicine
non-pharmacologic treatment
pulmonary rehabilitation
interdisciplinary care
thematic analysis
url https://www.dovepress.com/perspectives-and-attitudes-of-general-practitioners-towards-pharmacolo-peer-reviewed-fulltext-article-COPD
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