Article Text

Opportunities to improve asthma and COPD prevention and care: insights from the patient journey obtained through focus groups
  1. Aneisha Collins-Fairclough1,2,
  2. Karen Rideout2,3,
  3. Phalgun Joshi2,3,
  4. Jeremiah Philips2,
  5. Tony Lanier4,
  6. Santa Chow4,
  7. Dan Smith4,
  8. Alison Hoens5,
  9. J Mark FitzGerald1,3,
  10. Chris Rauscher2,
  11. Nardia Strydom6,7,
  12. Christopher Carlsten1,2
  1. 1 Division of Respiratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  2. 2 Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
  3. 3 Center for Lung Health, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
  4. 4 Legacy for Airway Health, Community Stakeholder Committee, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
  5. 5 Department of Physical Therapy, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  6. 6 Department of Family and Community Medicine, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
  7. 7 Department of Family Medicine, Providence Health Care, Vancouver, British Columbia, Canada
  1. Correspondence to Professor Christopher Carlsten; carlsten{at}ubc.ca

Abstract

Background The healthcare experiences of patients hold valuable insights for improving the quality of services related to their well-being. We therefore invited and explored the perspectives of patients living with asthma and chronic obstructive pulmonary disease (COPD) on their interaction with the systems supporting health, in order to identify opportunities to improve services to prevent, treat and manage these conditions.

Methods Two virtual focus groups were held in August 2021, one for adult asthma and one for COPD, to learn of patients’ experiences receiving care for these conditions in the Vancouver Coastal Health (VCH) region of British Columbia. Participants were recruited through online postings or their clinician. We discussed the care pathway for each condition and invited participants to share their experiences of the past 5 years, specifically their reflections on the process, including feelings, points of praise and frustration, and opportunities for improvement in this context. Composite patient journey maps were developed for each condition to reflect the experiences shared. Audio recordings of the focus groups were transcribed and used in qualitative data analysis.

Results Thematic analysis revealed the following as possible areas for improvement: low public awareness of asthma and COPD and associated risk factors, non-standardised diagnosis pathways that delay diagnosis, and inconsistency in delivering valued aspects of care such as supports for self-management, trust-inspiring acute care, empowering patient communication and timely access to care.

Conclusion We successfully used focus groups to generate composite journey maps of the experiences of patients living with asthma (n=8) and COPD (n=9) to identify features that these patients consider important for improving the healthcare system for asthma and COPD in VCH. Health professionals, decision makers and patient advocates in VCH and beyond can consider these insights when evaluating, and planning changes to, current practices and policies in service delivery.

  • Asthma
  • Patient Participation
  • Chronic disease management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Deceased JMF deceased

  • Contributors AC-F and KR led design, analyses and drafting of the manuscript, with contributions from all coauthors. All coauthors, except JMF (deceased), reviewed the manuscript and approved the contents. CC is the guarantor.

  • Funding Legacy for Airway Health supported this project using its own operating resources.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.