Patient with COPD or heart failure (HF) often attend the emergency department when they experience an exacerbation because they perceive GP services to be a ‘waste of time’ in an emergency. This was one of the findings that emerged in new research conducted by Guy's and St Thomas' NHS Foundation Trust, King's College London, and the University of West London.
In the mixed methods study, many patients reported that they regarded GPs as generalists and so, when they were acutely unwell, they preferred to attend the ED to access specialist care. In interviews, patients said they felt the ED provides ‘quick access’ for their emergency medical situation, and employs ‘the main people’ who are competent to manage their exacerbation.
Presenting the findings in BMJ Open Respiratory Research, the authors say the results of the study highlight the need to improve patients’ perceptions of the role of GP services in managing HF and COPD crises. They say it is important to “increase patients’ trust in GP services so that they will be used in a more timely manner to prevent exacerbations of symptoms” require ED admission.
“This is highly relevant in the current health climate where more than 30 per cent of population lives with one or more of long-term conditions and there is necessity for redesigning the future service provision in primary and emergency care to meet the high demand,” they add.
The findings are based on a series of semistructured interviews with 15 patients and six family members or carers of patients attending ED with exacerbation of COPD or HF.