Document Detail

A qualitative study of factors influencing family physicians' prescription of the Written Asthma Action Plan in primary care in Singapore.
MedLine Citation:
PMID:  19296031     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The Written Asthma Action Plan (WAAP) educates patients on the early recognition and treatment of deteriorating asthma. It has been adopted in Singapore polyclinics and restructured hospitals in the past few years as recommended by the Singapore National Asthma Programme. Local asthma patients can choose to be treated by family physicians at public polyclinics or by private general practitioners (GPs). In a previous study, half of the physicians in primary care self-reported that they formulated an asthma action plan for their patients, but little is known about their actual practices. This qualitative study explored family physicians' views of WAAP and its implementation in primary care in Singapore. METHODS: Qualitative data was obtained for 29 participants from polyclinics, GP clinics or locum doctors at five separate focus group discussions. The data was coded using NVivo-7 software, audited and analysed to identify emergent themes. RESULTS: The participants generally perceived the usefulness of WAAP. While WAAP was widely used in polyclinics, GPs rarely used it. Even in polyclinics, usage varied and was associated with participants' training and practice of WAAP and task substitution to nurses. They perceived that WAAP would benefit only selected motivated patients who could understand and use it. They were hampered by language barriers in educating their multiracial patients and the perceived lack of time related to patient loads in polyclinics. The GPs lacked training and practice, role models and relied on verbal instructions as a personalised form of care delivery. CONCLUSION: Family physicians generally perceived WAAP as useful, but implementation was hampered by lack of training and practice, language barriers and perceived benefits for patients.
N C Tan; I H Tay; A Ngoh; M Tan
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Singapore medical journal     Volume:  50     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-03-19     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  160-4     Citation Subset:  IM    
SingHealth Polyclinics-Pasir Ris, 1 Pasir Ris Drive 4, #01-11, Singapore.
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MeSH Terms
Asthma / therapy*
Attitude of Health Personnel
Clinical Competence
Health Knowledge, Attitudes, Practice
Patient Care Planning
Patient Education as Topic*
Patient-Centered Care
Physician-Patient Relations
Physicians, Family
Primary Health Care
Self Care*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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