Qualitative evaluation of a self-management program for COPD in the context of multimorbidity in Australian General practice

Self-management support for chronic obstructive pulmonary disease (COPD) is known to be effective. The Activating Primary Care COPD Patients with Multimorbidity APCOM) program, being further tested in Australian general practice, aims to improve patients’ health outcomes through individual, tailored, self-management support delivered by trained practice nurses (PNs). This qualitative evaluation aims to understand PN, GP and patient experiences of the APCOM program. Intervention group PNs, GPs and patients were invited to participate in semi-structured interviews. Interview guides were based on the Health Belief Model for patients and the Normalisation Process Theory for health professionals. Transcripts were thematically analysed guided by interpretive description. Nine PNs, three GPs, and 17 patients from intervention practices were interviewed. Both patients and providers expressed positive experiences with the program. Patients felt the program provided them with the tools to self-manage a potential exacerbation using their COPD Action Plan. Some patients described continuing with positive health behaviours learnt from PNs, however, others struggled with self-motivation. GPs and PNs highlighted the importance of teamwork when caring for COPD patients and considered that the APCOM program was an opportunity for expanding care, including care plans. Nurse-led self-management interventions for chronic disease, such as the APCOM program, can improve patient access to timely, collaborative care in general practice. It would be preferable to provide self-management support for patients with COPD closer to diagnosis. Ongoing funding for PN training and time to deliver patient education are required to sustain the program.

ID 1059 in Abstract Book.