School of Health and Related Research, University of Sheffield, Sheffield, UK.
J Health Serv Res Policy. 2010 Apr;15 Suppl 2:41-6. doi: 10.1258/jhsrp.2009.009101. Epub 2010 Feb 10.
Patients with chronic obstructive pulmonary disease (COPD) have recently been offered severe weather warnings and medication reminders using an automated telephone service and interactive voice recognition technology. Our aim was to explore patients' and health care staffs' perceptions and experiences of the technologies, their contribution to the management of COPD and implementation issues.
Qualitative semi-structured telephone interviews were undertaken with 18 patients and six staff from five primary care centres in the Bradford area, England. Interview transcripts were thematically analysed.
Patients considered the telephone service was an appropriate way to deliver information but there was some variation in perceived usefulness. Many patients praised the service, valuing reassurance and medication reminders, but others were indifferent and even critical. Criticism tended to reflect scepticism over the reliability of weather forecasts information rather than the automated telephone service itself. There was limited impact on the management strategies of patients apart from some patients ordering medication. Primary care staff considered the service a success but some felt that it lacked participation by hard-to-reach groups (non-English speaking, mild COPD patients). Our concerns about the resource implications of successful implementation were also raised.
An automated telephone service was generally acceptable to patients but changes in COPD management were limited, possibly because the patients already had a good understanding of their condition and self-management strategies. Implications for practice include the need for strategies to target hard-to-reach groups which may need more resources.
最近,利用自动化电话服务和交互式语音识别技术,为慢性阻塞性肺疾病(COPD)患者提供恶劣天气预警和药物提醒。我们旨在探讨患者和医护人员对这些技术的看法和体验、它们对 COPD 管理的贡献以及实施中的问题。
在英格兰布拉德福德地区的五个初级保健中心,对 18 名患者和 6 名工作人员进行了定性半结构式电话访谈。对访谈记录进行了主题分析。
患者认为电话服务是传递信息的合适方式,但对其有用性的看法存在差异。许多患者对服务表示赞赏,重视得到安慰和药物提醒,但也有一些患者漠不关心,甚至持批评态度。批评往往反映出对天气预报信息可靠性的怀疑,而不是对自动化电话服务本身的怀疑。除了一些患者订购药物外,对患者管理策略几乎没有影响。初级保健工作人员认为该服务取得了成功,但一些人认为它缺乏对难以接触到的群体(非英语使用者、轻度 COPD 患者)的参与。我们对成功实施所涉及的资源问题也表示关注。
自动化电话服务普遍被患者接受,但 COPD 管理的变化有限,这可能是因为患者已经对自己的病情和自我管理策略有了很好的了解。对实践的影响包括需要针对难以接触到的群体制定策略,这可能需要更多的资源。