ArticleScandinavian journal of primary health care2016
Time pressured deprioritization of COPD in primary care: a qualitative study.
Article in Scandinavian journal of primary health care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Tailored or adapted interventions for adults with chronic obstructive pulmonary disease and at least one other long-term condition: a mixed methods review.The Cochrane database of systematic reviews · 2021Pooled it
- General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research.BMC family practice · 2020Pooled it
- Working with patients suffering from chronic diseases can be a balancing act for health care professionals - a meta-synthesis of qualitative studies.BMC health services research · 2020Pooled it
- Pulmonary specialist health coach consultation model: a randomized controlled trial.Annals of the American Thoracic Society · 2026Trial
- Primary care patients with mild or stable chronic obstructive pulmonary disease need more support in disease management: a secondary analysis of a cluster randomized controlled trial.Scandinavian journal of primary health care · 2023Trial
- Patient outcomes following GPs' educations about COPD: a cluster randomized controlled trial.NPJ primary care respiratory medicine · 2020Trial
- Trial
- Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial.Trials · 2017Trial
- Asthma/COPD clinics increases adherence to management guidelines and associates with less morbidity and lower all-cause mortality - a prospective cohort study.NPJ primary care respiratory medicine · 2026Article
- Experiences of Continuity of Care Among Registered Nurses Caring for Patients With Chronic Obstructive Pulmonary Disease in Primary Care: A Qualitative Study.Journal of advanced nursing · 2025Article
- Disproportionately raised risk of adverse outcomes in patients with COPD and comorbid type 2 diabetes or depression: Swedish register-based cohort study.Respiratory research · 2025Article
- Factors Associated with Patient Education in Patients with Chronic Obstructive Pulmonary Disease (COPD) - A Primary Health Care Register-Based Study.International journal of chronic obstructive pulmonary disease · 2024Article
- Patients' experiences with participating in a team-based person-centred intervention for patients at risk of or diagnosed with COPD in general practice.Pilot and feasibility studies · 2023Article
- The effects of an innovative GP-physiotherapist partnership in improving COPD management in primary care.BMC primary care · 2023Article
- General practice management of COPD patients following acute exacerbations: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Does multimorbidity result in de-prioritisation of COPD in primary care?NPJ primary care respiratory medicine · 2023Article
- Facilitators and barriers to professional nurses implementing integrated services in urban primary health care clinics in Kavango East region, Namibia.African journal of primary health care & family medicine · 2022Article
- The voice of the self: a typology of general practitioners' emotional responses to situational and contextual stressors.Scandinavian journal of primary health care · 2022Article
- Age- and gender-based comorbidity categories in general practitioner and pulmonology patients with COPD.NPJ primary care respiratory medicine · 2022Article
- Lack of COPD-Related Follow-Up Visits and Pharmacological Treatment in Swedish Primary and Secondary Care.International journal of chronic obstructive pulmonary disease · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify factors that hinder discussions regarding chronic obstructive pulmonary disease (COPD) between primary care physicians (PCPs) and their patients in Sweden.
settingPrimary health care centres (PHCCs) in Stockholm, Sweden. SUBJECTS: A total of 59 PCPs.
designSemi-structured individual and focus-group interviews between 2012 and 2014. Data were analysed inspired by grounded theory methods (GTM).
resultsTime-pressured patient-doctor consultations lead to deprioritization of COPD. During unscheduled visits, deprioritization resulted from focusing only on acute health concerns, while during routine care visits, COPD was deprioritized in multi-morbid patients. The reasons PCPs gave for deprioritizing COPD are: "Not becoming aware of COPD", "Not becoming concerned due to clinical features", "Insufficient local routines for COPD care", "Negative personal attitudes and views about COPD", "Managing diagnoses one at a time", and "Perceiving a patient's motivation as low''.
conclusionsDe-prioritization of COPD was discovered during PCP consultations and several factors were identified associated with time constraints and multi-morbidity. A holistic consultation approach is suggested, plus extended consultation time for multi-morbid patients, and better documentation and local routines. KEY POINTS: Under-diagnosis and insufficient management of chronic obstructive pulmonary disease (COPD) are common in primary health care. A patient-doctor consultation offers a key opportunity to identify and provide COPD care. Time pressure, due to either high number of patients or multi-morbidity, leads to omission or deprioritization of COPD during consultation. Deprioritization occurs due to lack of awareness, concern, and local routines, negative personal views, non-holistic consultation approach, and low patient motivation. Better local routines, extended consultation time, and a holistic approach are needed when managing multi-morbid patients with COPD.
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