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Reasons for Accident and Emergency department attendance by people with chronic obstructive pulmonary disease or heart failure: Recipients and providers' perspectives. An exploratory study

Lee, Jeong Su, Lempp, Heidi, Srivastava, Vivek and Barley, Elizabeth (2018) Reasons for Accident and Emergency department attendance by people with chronic obstructive pulmonary disease or heart failure: Recipients and providers' perspectives. An exploratory study BMJ Open Respiratory Research, 5 (1).

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Abstract

Introduction Fifteen million people are affected by one or more long-term conditions in England. The cost of caring for this patient group increases every year. Several studies have been conducted to find out why people with those conditions choose to access Accident and Emergency (A&E) frequently. To our knowledge, there is no study that compares the three groups (patients, family members and hospital clinicians), and this approach may enhance understanding of A&E admissions in England. Therefore, an exploratory study was undertaken to identify key factors that contribute to A&E admissions as perceived by patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF), their family members (or carers) and hospital clinicians. Methods A mixed methods approach was undertaken: (1) semistructured interviews with patients and their family members (or carers) and (2) a self-developed survey with hospital clinicians. A purposive sample of 15 patients (9 COPD, 6 HF), 6 family members and carers (2 COPD, 4 HF) and 13 hospital clinicians (5 doctors, 8 nurses) participated in the study. Results The patients' main reason for A&E admission was severe exacerbation of their symptoms and all three parties (patients, family members or carers, hospital clinicians) agreed with this decision. Three key factors were highlighted in relation to A&E attendance: (1) patients' health-seeking behaviour, (2) perceptions about general practitioner (GP) and A&E services by patients and (3) patients' attitudes towards managing their own conditions. Conclusions Improving patients' perceptions of GP services in the management of exacerbations of HF and COPD will be important to increase patients' trust in GP services so that patients will access primary care in a timely manner to prevent exacerbations of symptoms that require A&E admission. This may be achieved by developing a close collaboration between the patients, family members (carers) and hospital clinicians over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Lee, Jeong Su
Lempp, Heidi
Srivastava, Vivek
Barley, Elizabethe.barley@surrey.ac.uk
Date : 24 January 2018
Funders : NIHR.
DOI : 10.1136/bmjresp-2017-000244
Copyright Disclaimer : 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 and the use is non-commercial. See: http:// creativecommons. org/ licenses/ by- nc/ 4. 0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Depositing User : Diane Maxfield
Date Deposited : 28 Mar 2019 17:14
Last Modified : 28 Mar 2019 17:14
URI: http://epubs.surrey.ac.uk/id/eprint/850905

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