You are here

Article Text

Article menu

Download PDFPDF

XML
Respiratory medicine
Original research
Patient preferences for asthma management: a qualitative study
  1. Christina Baggott1,
  2. Amy Chan2,
  3. Sally Hurford1,
  4. James Fingleton1,
  5. Richard Beasley1,
  6. Matire Harwood3,
  7. Helen K Reddel4,
  8. William Mark Magnus Levack5
  1. 1Medical Research Institute of New Zealand, Wellington, New Zealand
  2. 2School of Pharmacy, The University of Auckland, Auckland, New Zealand
  3. 3Te Kupenga Hauora Maori, University of Auckland, Auckland, New Zealand
  4. 4Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia
  5. 5Department of Medicine, University of Otago, Wellington, New Zealand
  1. Correspondence to Dr Christina Baggott; christina.baggott{at}mrinz.ac.nz

Abstract

Objective Preference for asthma management and the use of medications is motivated by the interplay between lived experiences of asthma and patients’ attitudes towards medications. Many previous studies have focused on individual aspects of asthma management, such as the use of preventer and reliever inhalers. The aim of this qualitative study was to explore the preferences of patients with mild-moderate asthma for asthma management as a whole and factors that influenced these preferences.

Design A qualitative study employing qualitative descriptive analysis situated within a constructionist epistemology to analyse transcribed audio recordings from focus groups.

Setting Three locations within the greater Wellington area in New Zealand.

Participants Twenty-seven adults with self-reported doctor’s diagnosis of asthma, taking short-acting beta-agonists alone or inhaled corticosteroids with or without long-acting beta2-agonist, who had used any inhaled asthma medication within the last month.

Results Four key areas described preferences for asthma management. Preferences for self-management: participants wanted to be in control of their asthma and developed personal strategies to achieve this. Preferences for the specific medications or treatment regimen: participants preferred regimens that were convenient and reliably relieved symptoms. Preferences for inhaler devices: devices that had dose counters and were easy to use and portable were important. Preferences for asthma services: participants wanted easier access to their inhalers and to be empowered by their healthcare providers. Participant preferences within each of these four areas were influenced by the impact asthma had on their life, their health beliefs, emotional consequences of asthma and perceived barriers to asthma management.

Conclusions This study illustrates the interaction of the lived experience of asthma, factors specific to the individual, and factors relating to asthma treatments in shaping patient preferences for asthma management. This aids our understanding of preferences for asthma management from the patient perspective.

Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN12619000601134).

  • asthma
  • adult thoracic medicine
  • qualitative research
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-037491

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors CB, HKR, JF, RB and WMML conceived the idea. The study protocol was written by CB, AC, JF, HKR and WMML in consultation with MH on Māori perspectives. CB, AC and SH collected the data. Transcription was conducted by a commercial company, all transcript were checked against the audio recordings by CB. Coding was undertaken by CB and AC. Data analysis and interpretation were undertaken by CB, AC, MH, HKR and WMML. All authors had full access to the audio files, transcripts and coding. CB and WMML wrote the first draft of the manuscript, and all authors contributed to the final version.

    • Funding The study was funded by a grant from Research for Life (2019/300) and the study sponsor the Medical Research Institute of New Zealand (MRINZ). The MRINZ receives Independent Research Organisation funding from the Health Research Council of New Zealand.

    • Competing interests CB reports personal fees from AstraZeneca and Novartis. AC reports grants from Maurice and Phyllis Paykel Trust, Innovate UK, NZPERF, U21, A+Charitable Trust and consultancy fees from Janssen-Cilag, and Spoonful of Sugar Ltd. JF reports grants from Health Research Council of New Zealand, AstraZeneca, GlaxoSmithkline and Genentech; and personal fees and non-financial support from AstraZeneca, GlaxoSmithkline and Boehringer Ingleheim. RB reports grants from Health Research Council of New Zealand, Genentech, AstraZeneca, GlaxoSmithKline; and personal fees from AstraZeneca, Avillion and Theravance. MH reports grants from Health Research Council of New Zealand. HR reports grants from GlaxoSmithKline, AstraZeneca and Novartis; personal fees from AstraZeneca, GlaxoSmithKline, Merck, Novartis, Teva, Sanofi Genzyme and Boehringer Ingelheim; and is chair of the Global Initiative for Asthma scientific committee.

    • Patient consent for publication Not required.

    • Ethics approval The study had ethical approval from the Central Health and Disability Ethics Committee (19/CEN/52).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. De-identified access to transcripts from focus groups will be shared 2 years after article publication with no end date. These data will be available to researchers who provide a methodologically sound proposal for the purposes of achieving specific aims outlined in that proposal. Proposals should be directed to the study sponsor the Medical Research Institute of New Zealand by emailing Prof Richard Beasley (richard.beasley@mrinz.ac.nz). Requests to access data to undertake hypothesis driven research will not be unreasonably withheld. To gain access, data requesters will need to sign a data access agreement and to confirm that data will only be used for the agreed purpose for which access was granted.