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. 2020 Apr 30;70(694):e303-e311.
doi: 10.3399/bjgp20X708869. Print 2020 May.

Understanding how patients establish strategies for living with asthma: a qualitative study in UK primary care as part of IMP2ART

Luke Daines  1 , Susan Morrow  1 , Sharon Wiener-Ogilvie  2 , Caroline Scott  3 , Liz Steed  4 , Stephanie Jc Taylor  4 , Hilary Pinnock  1
Affiliations

Understanding how patients establish strategies for living with asthma: a qualitative study in UK primary care as part of IMP2ART

Luke Daines et al. Br J Gen Pract. .

Abstract

Background: In the context of a variable condition such as asthma, patient recognition of deteriorating control and knowing what prompt action to take is crucial. Yet, implementation of recommended self-management strategies remains poor.

Aim: To explore how patients with asthma and parents/carers of children with asthma develop and establish recommended self-management strategies for living with asthma, and how clinicians can best support the process.

Design and setting: A qualitative study in UK primary care.

Method: Patients with asthma and parents/carers of children with asthma from 10 general practices were purposively sampled (using age, sex, and duration of asthma) to participate in focus groups or interviews between May 2016 and August 2016. Participants' experiences of health care, management of asthma, and views on supported self-management were explored. Interviews and focus group sessions were audio-recorded and transcribed verbatim. Iterative thematic analysis was conducted, guided by the research questions and drawing on habit theory in discussion with a multidisciplinary research team.

Results: A total of 49 participants (45 patients; 4 parents/carers) took part in 32 interviews and five focus groups. Of these, 11 reported using an action plan. Patients learnt how to self-manage over time, building knowledge from personal experience and other sources, such as the internet. Some regular actions, for example, taking medication, became habitual. Dealing with new or unexpected scenarios required reflective abilities, which may be supported by a tailored action plan.

Conclusion: Patients reported learning intuitively how to self-manage. Some regular actions became habitual; dealing with the unexpected required more reflective cognitive skills. In order to support implementation of optimal asthma self- management, clinicians should consider both these aspects of self-management and support, and educate patients proactively.

Keywords: asthma; habits; health planning; personalised asthma action plans; primary health care; self-management.

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Figures

Figure 1.
Figure 1.
Schema illustrating how self-management behaviours and skills may develop. The personal experience of asthma is commonly built up over time, shaped by individual-related factors and healthcare support. At any given time, an individual can draw on different skills to self-manage effectively, which can be thought of as automated actions (or ‘habits’), and other reflective skills required to process new or uncommon situations. HCP = healthcare professional.
See this image and copyright information in PMC

Comment in

  • Self-care strategies for asthma.
    Levy ML. Levy ML. Br J Gen Pract. 2020 Apr 30;70(694):222-223. doi: 10.3399/bjgp20X709469. Print 2020 May. Br J Gen Pract. 2020. PMID: 32354804 Free PMC article. No abstract available.

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