Chronic obstructive pulmonary disease (COPD) is a frequent disease of the lungs. Its prevalence was estimated to be 26% in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) I and 11% for GOLD II–IV in Austria. Globally, it ranks third in mortality rate. The particular challenge is that care for these patients falls short due to the lack of structured integrated care. The aim was to assess the current status of multiprofessional COPD care in Austria and identify gaps and potentials.
We conducted guided focus group interviews between March and July 2016 addressing current COPD care and treatment gaps with the following professional and interest groups: general practitioners, nurses, patients, pharmacists, physiotherapists and pulmonologists. We interviewed 23 patients and 27 healthcare professionals. The interviews were transcribed verbatim and coded into 12 relevant categories.
There needs to be a shift in thinking from treatment-based care to prevention. Patients, just like healthcare professionals, need periodic updates and comprehensive information on this disease. Creating internet platforms with useful information for COPD patients and solving the data privacy issues of the Austrian electronic medical record (ELGA) are also perceived as viable steps. There is a need and request for healthcare professionals to work as a team with clear COPD management guidelines in the outpatient sector, the establishment of outpatient rehabilitation centers as well as creating a new professional profile, the COPD nurse.
Current COPD care needs to be reorganized, particularly in the outpatient sector, to address the needs of patients and healthcare professionals.
Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB. Screening for chronic obstructive pulmonary disease using spirometry: summary of the evidence for the U.S. Preventive Services Task Force. Rockville: Agency for Healthcare Research and Quality (US); 2008.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128. https://doi.org/10.1016/S0140-6736(12)61728-0. CrossRefPubMed
OECD. Health at a glance: Europe 2012. 2012. http://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-europe-2012_9789264183896-en. Accessed 8 June 2017. CrossRef
Nowak P, Geißler W, Holzer U, Knauer C. Themenqualitätsbericht COPD. Wissenschaftlicher Ergebnisbericht im Auftrag des Bundesministeriums für Gesundheit. Berichtsreihe Fokus Qualität, Vol. 1. Wien: Gesundheit Österreich GmbH; 2013.
Bukert N. Ambulatory Care Sensitive Conditions. Potentiell vermeidbare stationäre Aufenthalte, entsprechende Diagnosen, Einflussfaktoren und Empfehlungen zur Durchführung von Untersuchungen. Graz: Institut für Sozialmedizin und Epidemiologie MUG; 2014.
Calvert D, Lim W, Rodrigo C, Turner A, Welham S. British Thoracic Society pilot care bundle project: a care bundles-based approach to improving standards of care in chronic obstructive pulmonary disease and community acquired pneumonia. Br Thorac Soc Rep. 2014;6(4):1–53.
Jakobschuk L. CFHI supports projects to improve care for COPD patients: teams from across Canada will implement leading practices. 2014. http://www.cfhi-fcass.ca/SearchResultsNews/2014/10/06/cfhi-supports-projects-to-improve-care-for-copd-patients-teams-from-across-canada-will-implement-leading-practices. Accessed 23 May 2017.
Mann B. Assessing the impact of implementing a hospital discharge COPD (chronic obstructive pulmonary disease) care bundle on the respiratory ward at West Middlesex University Hospital. 2012. https://www.nice.org.uk/sharedlearning/assessing-the-impact-of-implementing-a-hospital-discharge-copd-chronic-obstructive-pulmonary-disease-care-bundle-on-the-respiratory-ward-at-west-middlesex-university-hospital. Accessed 22 May 2017.
Index—SKAG. Salzburger Krankenanstaltengesetz. 2000. http://medizinrecht-pflegerecht.com/Organisationsrecht/Krankenanstalten/SKAG/skag%2030.php. Accessed 14 June 2017.
Kuckartz U. Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung. 3rd ed. 2016. p. 240.
Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken. 12th ed. Weinheim: Beltz; 2015. p. 152.
Kaiser R. Qualitative Experteninterviews. Konzeptionelle Grundlagen und praktische Durchführung. Wiesbaden: Springer; 2014. p. 17. Abb p.
European Lung White Book. Allied respiratory professionals. 2013. http://www.erswhitebook.org/chapters/allied-respiratory-professionals/. Accessed 8 June 2017.
Schermer T, van Weel C, Barten F, et al. Prevention and management of chronic obstructive pulmonary disease (COPD) in primary care: position paper of the European Forum for Primary Care. Qual Prim Care. 2008;16(5):363–77. PubMed
GOLD. Global strategy for the diagnosis, managemenet and prevention of COPD. 2017.
Jonsdottir H, Amundadottir OR, Gudmundsson G, et al. Effectiveness of a partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease: a pragmatic randomized controlled trial. J Adv Nurs. 2015;71(11):2634–49. https://doi.org/10.1111/jan.12728. CrossRefPubMed
Lavesen M, Ladelund S, Frederiksen AJ, Lindhardt BO, Overgaard D. Nurse-initiated telephone follow-up on patients with chronic obstructive pulmonary disease improves patient empowerment, but cannot prevent readmissions. Dan Med J. 2016;63(10):(pii):A5276.
Voncken-Brewster V, Tange H, de Vries H, Nagykaldi Z, Winkens B, van der Weijden T. A randomized controlled trial evaluating the effectiveness of a web-based, computer-tailored self-management intervention for people with or at risk for COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:1061–73. https://doi.org/10.2147/COPD.S81295. CrossRefPubMedPubMedCentral
Krueger RA, Casey MA. Focus groups. A practical guide for applied research. Thousand Oaks: SAGE; 2009.
Multiprofessional COPD care in Austria–challenges and approaches
Results of a qualitative study
MPH MA Firuzan Sari Kundt
Anna Maria Dieplinger
- Springer Vienna
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II