ArticleBJGP open2019
Feasibility of delivering integrated COPD-asthma care at primary and secondary level public healthcare facilities in Pakistan: a process evaluation.
Article in BJGP open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Perceptions, attitudes, and behaviors of asthma patients towards the use of short-acting β2-agonists: A systematic review.PloS one · 2023Pooled it
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Implementing lung health interventions in low- and middle-income countries: a FRESH AIR systematic review and meta-synthesis.The European respiratory journal · 2020Pooled it
- Mapping Peak Expiratory Flow in Healthy Pakistani Adults: Insights from Wah Cantt.Ethiopian journal of health sciences · 2025Article
- Article
- Prevalence of covid-19 among patients with chronic obstructive pulmonary disease and tuberculosis.Annals of medicine · 2023Article
- GRADE-ADOLOPMENT of clinical practice guidelines and creation of clinical pathways for the primary care management of chronic respiratory conditions in Pakistan.BMC pulmonary medicine · 2023Article
- Gaps in asthma diagnosis and treatment in low- and middle-income countries.Frontiers in allergy · 2023Article
- Article
- mHealth guideline training for non-communicable diseases in primary care facilities in Nigeria: a mixed methods pilot study.BMJ open · 2022Article
- Quality Standard Position Statements for Health System Policy Changes in Diagnosis and Management of COPD: A Global Perspective.Advances in therapy · 2022Article
- The Obstructive Lung Diseases Program: Integrated obstructive lung disease services within primary care in Pakistan.Pakistan journal of medical sciences · 2022Article
- Effectiveness of delivering integrated COPD care at public healthcare facilities: a cluster randomised trial in Pakistan.BJGP open · 2019Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 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.
aimTo understand how an integrated care package was experienced by care providers and patients, and to inform modifications prior to scaling up. DESIGN &
settingThe mixed-methods study was conducted as part of cluster randomised trials on integrated COPD and asthma care at 30 public health facilities.
methodThe care practices were assessed by analysing the clinical records of
resultsUtilisation 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.
conclusionThe 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.
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