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Are acute asthma presentations to the emergency department an opportunity for optimising long-term management? A qualitative study on beliefs and behaviours of healthcare professionals

Abstract:
Background: Guidelines recommend Emergency Department (ED) healthcare professionals (HCPs) ensure patients have a supply of inhaled corticosteroid on discharge after an acute asthma presentation. By optimising medication, acute asthma presentations to EDs are a potentially reachable moment to improve long-term asthma management as well as treating the acute exacerbation. Optimising medication for long-term asthma management requires behavioural changes from HCPs, which may be considered unacceptable or unfeasible. Understanding health beliefs and attitudes of HCPs who provide asthma treatment in emergency care is a critical step in determining whether interventions could be developed to address this. Aims: To explore the health beliefs, attitudes and behaviours of HCPs involved in the care of adult patients presenting to the ED with asthma. Methods: UK HCPs, purposively sampled for profession, experience and work setting, were invited to participate in a semi-structured face-to-face or online interview. These were conducted between November 2021 and June 2022. Eligible participants had experience of caring for patients with asthma in either the ED or primary care setting. Interviews were analysed with reflective thematic analysis. Results: 19 HCPs were interviewed. Four themes were identified, constructed around the beliefs and behaviours of HCPs: (1) Compassionate understanding, that is, recognising the accessibility of ED, patients' self-management and the emotional aspects of exacerbations, (2) Doing what is right for the patient, that is, maximising a reachable moment, (3) Tensions of capacity in the system, that is, acknowledging workload within ED and (4) ED as providers of preventative care. Conclusion: This study found HCPs recognise both the accessibility of the ED as a place for patients to seek help and that there are potential opportunities to optimise asthma control, but there are barriers to overcome. ED professionals may be willing to make changes in the best interests of the patients if they can follow guidelines and receive training.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/emermed-2024-214407

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Role:
Author
ORCID:
0000-0001-5215-2899
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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0001-5371-4427
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Role:
Author
ORCID:
0000-0003-4911-6082
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Role:
Author
ORCID:
0000-0002-3016-4925
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Role:
Author
ORCID:
0000-0003-0369-2885


Publisher:
BMJ Publishing Group
Journal:
Emergency Medicine Journal More from this journal
Volume:
42
Issue:
9
Pages:
608-614
Publication date:
2025-04-16
DOI:
EISSN:
1472-0213
ISSN:
1472-0205


Language:
English
Keywords:
Pubs id:
2407160
Local pid:
pubs:2407160
Source identifiers:
W4409499654
Deposit date:
2026-04-23
ARK identifier:
This ORA record was generated from metadata provided by an external service. It has not been edited by the ORA Team.

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