Abstract

Background:The aim of this study was to determine the impact of a novel general practitioner (GP):physiotherapist (PT) partnership in primary care in the management of COPD.

Methods:This pilot mixed-methods study was conducted in four general practices in Australia. ?At risk? participants (aged >40 years, ever smokers) and people with ?existing? COPD were invited to attend an assessment with a cardiorespiratory PT ateach practice. Pre/post-bronchodilator spirometry was performed. Those with airway obstruction (FEV1/FVC<0.7) were referred to their GP for medical management and received a tailored intervention by the PT including referral to pulmonary rehabilitation (PR). Following the intervention, seven clinicians and 12 patients consented to a semi-structured interview. Interviews were analysed using thematic analysis. Data were triangulated to determine acceptability.

Results:148 participants attended a baseline assessment from 748 people invited. 31 participants with airflow obstruction received the intervention. Following the intervention, 78% (21/27) eligible participants were referred to PR and where indicated, all participants had smoking cessation interventions initiated and physical activity counselling. During the interviews, all clinicians acknowledged that evidence-based practice (EBP) was enhanced and the PTs knowledge and skills complemented GP management. Patients felt empowered by the PTs knowledge. Logistical issues and resources were seen as barriers to successful implementation.

Conclusion:Results suggest that this model was effective in implementing aspects of COPD managementand was acceptable to patients and clinicians, facilitating EBP.