Developing an interprofessional collaboration for COPD patients in primary care: a participatory action research approach

在基层医疗中为慢性阻塞性肺病患者建立跨专业协作:一种参与式行动研究方法

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Abstract

Chronic obstructive pulmonary disease (COPD) is a respiratory disease which may significantly impact health status. To reduce symptoms and improve quality of life, pharmacological treatment should be complemented by addressing extrapulmonary traits and lifestyle- and psychosocial factors, such as physical deconditioning, decrease in muscle mass, smoking or depression. Treatment of these non-pharmacological traits is commonly conducted in a primary care setting and often requires multiple healthcare providers (HCPs). To provide complementary care, high quality interprofessional collaboration (IPC) is required. Therefore, our aim was to develop an IPC model for COPD patients treated in primary care. To achieve our aims, we used co-creation sessions (CCS), a recognised method within the participatory action research (PAR) approach. Co-creation, characterised by collaboration and a bottom-up strategy, has repeatedly shown to be suitable for developing care improvements. We recruited two independent groups of stakeholders to participate in six CCS in parallel. They were purposefully sampled and included patients and HCPs from both primary and secondary/tertiary care. Given the considerable overlap in results between the two independent teams, we developed a joint model which is ready to be pilot tested. Our model is based on current and local work methods and can be implemented in existing local contexts and structures. We noted some differences between the teams: the choice of the routing and timing of IPC commencement, and the choice for the communication platform. Using the PAR approach and co-creation, we developed an actionable IPC model in primary care for COPD patients.

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