Qualitative study of views of health professionals and patients on guided self management plans for asthma

doi:10.1136/bmj.321.7275.1507

BMJ 2000;321:1507-1510 ( 16 December )

General Practice

Qualitative study of views of health professionals and patients on guided self management plans for asthma

Editorial by Thoonen and van Weel

Alan Jones, senior lecturer, ^a Roisin Pill, professor of research, ^a Stephanie Adams, senior tutor. ^b

^a Department of General Practice, University of Wales College of Medicine, Health Centre, Llanedeyrn, Cardiff CF26 9PN, ^b School of Social Sciences and International Development, University of Swansea, Swansea SA2 8PP

Correspondence to: A Jones, Princess St Surgery, Gorseinon, Swansea SA4 2US research{at}gors.freeserve.co.uk

Objectives: To explore the views held by general practitioners,practice nurses, and patients about the role of guided self managementplans in asthmacare.
Design: Qualitative study using nine focus groupsthat each met on twooccasions.
Setting: SouthWales.
Subjects: 13 asthma nurses, 11 general practitioners(six with an interest in asthma), and 32 patients (13 adults compliantwith treatment, 12 non-compliant adults, and seventeenagers).
Results: Neither health professionals nor patientswere enthusiastic about guided self management plans, and, althoughfor different reasons, almost all participants were ambivalentabout their usefulness or relevance. Most professionals opposedtheir use. Few patients reported sustained use, and most feltthat plans were largely irrelevant to them. The attitudes associatedwith these views reflect the gulf between the professionals' conceptof the "responsible asthma patient" and the patients'view.
Conclusions: Attempts to introduce self guided managementplans in primary care are unlikely to be successful. A more patientcentred, patient negotiated plan is needed for asthma care inthecommunity.

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