Practices and Perceptions of public & private, general medical practitioners (GPs) in rural India for diagnosis & management of asthma & COPD

Clinical Research Results Abstract Introduction: Chronic respiratory symptoms are common and there is need to understand the practices of primary care practitioners ‘GPs’ who provide the majority of healthcare for populations in rural India. We aimed to explore the perceptions of public & private primary care physicians (GPs) in rural India of how they manage asthma and COPD. Methods: We interviewed 18 ‘GPs’, purposively sampled from survey responses to provide diverse perspectives, to understand (using vignettes) how they diagnose and manage asthma and COPD and explore perceived barriers and facilitators to providing respiratory care. In-depth interviews were audio recorded and transcribed verbatim for thematic analysis. Results: GPs listed a number of clinical features that helped them to differentiate asthma and COPD, but none of the GPs were involved in performing pulmonary function tests as they did not have necessary facilities. With one exception all the GPs suggested involving other health care workers for early detection, referral and follow-up of asthma and COPD cases. GPs highlighted lack of community awareness, self-treatment by patients, lack of specialised instruments (such as spirometers), limited facilities and poor knowledge among GPs as challenges. Access to telephone advice from a senior colleague, specialist or peer helped. All the GPs are willing to attend trainings and upskilling workshops/meetings/conferences if the local hospital (King Edward Memorial Hospital: KEM) takes the initiative. None of the GPs were sure about whether there was a national programme for asthma and COPD in India (as for TB and HIV) but supported the idea of a programme to include raising community awareness. Discussion: There is a need to build the capacity of GPs in rural part of India for proper diagnosis and management of asthma and COPD. KEM hospital should arrange certificate courses for GPs. Research into strategies for improving respiratory care are a priority. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Funded by the NIHR Global Health Research Unit in Respiratory Health (RESPIRE) at the Usher Institute, University of Edinburgh. References and Clinical Trial Registry Information Not applicable