Have we got the right focus in asthma care in general practice? A qualitative study.

BACKGROUND AND OBJECTIVES Asthma presentations are common in general practice, but opportunities to control asthma are often missed. The aim of this study was to explore how general practitioners (GPs) and practice nurses (PNs) deliver asthma care, with particular attention to perceived roles and challenges, and ways to improve management. METHOD Using a qualitative approach, semi-structured interviews were conducted with GPs and PNs working in an area of cultural diversity and socioeconomic disadvantage in western Sydney. Inductive thematic analysis was undertaken. RESULTS Nineteen interviews were conducted, with nine GPs and 10 PNs. The main focus of asthma care was on acute presentations, with less emphasis on follow-up and preventive care and underuse of general practice chronic disease models of care. PN roles were generally limited to acute asthma assessment and triage. GPs did not commonly use spirometry or access non-GP specialist input. DISCUSSION Asthma care in general practice may be improved by a greater focus on prevention and control, including through follow-up after acute presentations, enhanced collaboration between GPs and PNs, and supportive practice models.