Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK.
School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Eur J Gen Pract. 2024 Dec;30(1):2407594. doi: 10.1080/13814788.2024.2407594. Epub 2024 Sep 27.
5.4 million people in the UK have asthma, with one third experiencing suboptimal control, leading to co-morbidities and increased healthcare use. A quarter of people with long-term conditions informally access peer support through online health communities (OHCs). However, integrating online peer support into primary care services to facilitate self-management is a new concept.
To develop together with stakeholders the content, delivery, and recruitment strategy of a digital social intervention to promote use of online peer support amongst asthma patients in primary care.
Data was collected by qualitative, audio-recorded, one-to-one interviews with clinicians, and focus groups with patients with asthma from East London general practices. The topic guide was informed by patient and public involvement work. Data collected was iterative (i.e. new ideas were added to subsequent interviews and focus groups). Verbatim transcripts were uploaded to NVivo12 and thematically analysed.
Twenty patients from several ethnicities participated across five focus groups, and three general practitioners and three practice nurses were interviewed. The study's outputs included: the intervention's face-to-face content; content of clinician training; patient-facing leaflets/material; and a survey to recruit eligible patients. An intervention consisting of a structured consultation with a primary care clinician followed by OHC engagement, was developed based on three generated themes: 'introducing OHCs', describing how clinicians should introduce OHCs; 'OHC engagement', describing factors influencing OHC engagement; and 'clinician training'.
Findings will assist clinicians in consultations about supporting self-management of patients through OHCs. Future research should evaluate feasibility, effectiveness, and cost-effectiveness of such support.
英国有 540 万人患有哮喘，其中三分之一的人控制效果不佳，导致合并症和增加医疗保健的使用。四分之一的长期病患者通过在线健康社区（OHC）非正式地获得同伴支持。然而，将在线同伴支持整合到初级保健服务中以促进自我管理是一个新概念。
与利益相关者共同制定数字社交干预措施的内容、交付和招募策略，以促进初级保健中哮喘患者使用在线同伴支持。
通过对来自东伦敦全科医生的临床医生和哮喘患者的一对一访谈和焦点小组，以定性、录音的方式收集数据。主题指南是根据患者和公众参与工作制定的。收集的数据是迭代的（即，新想法被添加到后续的访谈和焦点小组中）。逐字记录被上传到 NVivo12 并进行主题分析。
来自不同种族的 20 名患者参加了五个焦点小组，有三名全科医生和三名护士接受了采访。该研究的结果包括：面对面干预内容；临床医生培训内容；面向患者的传单/材料；以及招募合格患者的调查。基于三个生成的主题，开发了一种干预措施，包括与初级保健临床医生进行结构化咨询，然后参与 OHC：“介绍 OHC”，描述临床医生应该如何介绍 OHC；“OHC 参与”，描述影响 OHC 参与的因素；和“临床医生培训”。
研究结果将有助于临床医生在咨询中支持患者通过 OHC 进行自我管理。未来的研究应评估这种支持的可行性、有效性和成本效益。
