التفاصيل البيبلوغرافية
| العنوان: |
Feasibility of delivering integrated COPDasthma care at primary and secondary level public healthcare facilities in Pakistan: a process evaluation. |
| المؤلفون: |
Khan, Muhammad Amir, Khan, Muhammad Ahmar, Walley, John D., Khan, Nida, Sheikh, Faisal Imtiaz, Ali, Saima, Salahuddin, Ehsan, King, Rebecca, Khan, Shaheer Ellahi, Manzoor, Farooq, Khan, Haroon Jehangir |
| المصدر: |
BJGP Open; 2019, Vol. 3 Issue 1, p1-12, 12p |
| مصطلحات موضوعية: |
OBSTRUCTIVE lung diseases, ASTHMA treatment, PRIMARY care, FEASIBILITY studies |
| مصطلحات جغرافية: |
PAKISTAN |
| مستخلص: |
Background: In Pakistan, the estimated prevalence of chronic obstructive pulmonary disease (COPD) and asthma are 2.1% and 4.3% respectively, and existing care is grossly lacking both in coverage and quality. An integrated approach is recommended for delivering COPD and asthma care at public health facilities. Aim: To understand how an integrated care package was experienced by care providers and patients, and to inform modifications prior to scaling up. Design & setting: The mixed-methods study was conducted as part of cluster randomised trials on integrated COPD and asthma care at 30 public health facilities. Method: The care practices were assessed by analysing the clinical records of n = 451 asthma and n = 313 COPD patients. Semi-structured interviews with service providers and patients were used to understand their care experiences. A framework approach was applied to analyse and interpret qualitative data. Results: Utilisation of public health facilities for chronic lung conditions was low, mainly because of the non-availability of inhalers. When diagnosed, around two-thirds (69%) of male and more than half (55%) of female patients had severe airway obstruction. The practice of prescribing inhalers differed between intervention and control arms. Patient non-adherence to follow-up visits remained a major treatment challenge (though attrition was lower and slower in the intervention arm). Around half of the male responders who smoked at baseline reported having quit smoking. Conclusion: The integrated care of chronic lung conditions at public health facilities is feasible and leads to improved diagnosis and treatment in a low-income country setting. The authors recommend scaling of the intervention with continued implementation research, especially on improving patient adherence to treatment. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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