Twelve barriers to COPD diagnosis in France: a comparative qualitative study
Background Chronic obstructive pulmonary disease (COPD) is a common treatable disease often diagnosed in patients with risk factors after a prolonged period with suggestive symptoms. Our qualitative study aimed to identify barriers to establishing diagnosis in the natural history of this condition.M...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/12/1/e002708.full |
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| author | Maxime Patout Laurie Fraticelli Maéva Zysman Olivier Le Rouzic Elisabetta Scanferla Clémence Martin Mathieu Delorme Cécilia Nocent-Ejnaini Guillaume Roucoux Lize Kiakouama Maleka Annaig Ozier Yassine Benarbia Lize Kiakouama Olivier Le Rouzic Jean-Paul Vasseur Marie-Agnès Wiss-Laurent Carla Zonca Nissrine Erraji Matthieu Chanard Fabienne Peretz Catherine Beseme Antonio Correira Dos Santos Héla Saïdi Lynda Saïl |
| author_facet | Maxime Patout Laurie Fraticelli Maéva Zysman Olivier Le Rouzic Elisabetta Scanferla Clémence Martin Mathieu Delorme Cécilia Nocent-Ejnaini Guillaume Roucoux Lize Kiakouama Maleka Annaig Ozier Yassine Benarbia Lize Kiakouama Olivier Le Rouzic Jean-Paul Vasseur Marie-Agnès Wiss-Laurent Carla Zonca Nissrine Erraji Matthieu Chanard Fabienne Peretz Catherine Beseme Antonio Correira Dos Santos Héla Saïdi Lynda Saïl |
| collection | DOAJ |
| description | Background Chronic obstructive pulmonary disease (COPD) is a common treatable disease often diagnosed in patients with risk factors after a prolonged period with suggestive symptoms. Our qualitative study aimed to identify barriers to establishing diagnosis in the natural history of this condition.Methods An inductive thematic analysis was performed on structured interviews with patients, general practitioners (GPs) and pulmonologists in France. Inclusion depended on criteria to generate two purposive samples (patients and physicians). Recruitment occurred online. Data collection proceeded until 15 patients and 15 physicians (eight pulmonologists, seven GPs) were interviewed. Data saturation was checked and achieved. The interviews were transcribed and coded in NVivo and triangulated between two researchers. The article respects the consolidated criteria for reporting qualitative research guidelines.Results Three phases in the patients’ clinical pathway to diagnosis and 12 barriers were found: Phase 1 (symptoms before consultation; n=4), lack of COPD knowledge, symptom denial, fear of lung cancer, and delayed general practice consultations; Phase 2 (primary care; n=3), letting bronchitis become chronic, priority to diseases with similar symptoms and/or more serious diseases, lack of COPD screening devices, time and curative treatments; Phase 3 (specialised medicine; n=5), treatment before diagnosis, late referral to pulmonologists, difficulty in accessing specialists and examination results, patient’s reluctance to undergo further examinations, and need for additional tests to confirm a diagnosis.Conclusion People unaware of their COPD condition can encounter up to 12 barriers, which may combine before obtaining a formal diagnosis. Patients, GPs, pulmonologists and the state health authorities share responsibility for addressing these barriers and enhancing the care pathway. |
| format | Article |
| id | doaj-art-8aef7a395e734151b660fd384890ffcb |
| institution | Kabale University |
| issn | 2052-4439 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-8aef7a395e734151b660fd384890ffcb2025-01-23T06:45:09ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392025-01-0112110.1136/bmjresp-2024-002708Twelve barriers to COPD diagnosis in France: a comparative qualitative study Maxime Patout0Laurie Fraticelli1Maéva Zysman2Olivier Le Rouzic3Elisabetta Scanferla4Clémence MartinMathieu Delorme5Cécilia Nocent-Ejnaini6Guillaume Roucoux7Lize Kiakouama Maleka8Annaig Ozier9Yassine BenarbiaLize KiakouamaOlivier Le RouzicJean-Paul VasseurMarie-Agnès Wiss-LaurentCarla ZoncaNissrine ErrajiMatthieu ChanardFabienne PeretzCatherine BesemeAntonio Correira Dos SantosHéla SaïdiLynda SaïlPulmonology and Sleep Department, Sorbonne University, Paris, FranceUniversity Lyon 1 Laboratory Systemic Health Course P2S, Lyon, Auvergne-Rhône-Alpes, FranceCHU de Bordeaux, Bordeaux, FranceInserm U1019, University of Lille, F-59000 Lille, FranceParis Cité University, Paris, Île-de-France, FranceCardio-Thoracic Research Centre Bordeaux, Bordeaux, Aquitaine, FranceCentre Hospitalier de la Côte Basque, Bayonne, Aquitaine, FranceIndependent researcher, Paris, FranceLa Croix-Rousse Hospital, Lyon, Auvergne-Rhône-Alpes, FranceClinique Saint Augustin, Bordeaux, Aquitaine, FranceBackground Chronic obstructive pulmonary disease (COPD) is a common treatable disease often diagnosed in patients with risk factors after a prolonged period with suggestive symptoms. Our qualitative study aimed to identify barriers to establishing diagnosis in the natural history of this condition.Methods An inductive thematic analysis was performed on structured interviews with patients, general practitioners (GPs) and pulmonologists in France. Inclusion depended on criteria to generate two purposive samples (patients and physicians). Recruitment occurred online. Data collection proceeded until 15 patients and 15 physicians (eight pulmonologists, seven GPs) were interviewed. Data saturation was checked and achieved. The interviews were transcribed and coded in NVivo and triangulated between two researchers. The article respects the consolidated criteria for reporting qualitative research guidelines.Results Three phases in the patients’ clinical pathway to diagnosis and 12 barriers were found: Phase 1 (symptoms before consultation; n=4), lack of COPD knowledge, symptom denial, fear of lung cancer, and delayed general practice consultations; Phase 2 (primary care; n=3), letting bronchitis become chronic, priority to diseases with similar symptoms and/or more serious diseases, lack of COPD screening devices, time and curative treatments; Phase 3 (specialised medicine; n=5), treatment before diagnosis, late referral to pulmonologists, difficulty in accessing specialists and examination results, patient’s reluctance to undergo further examinations, and need for additional tests to confirm a diagnosis.Conclusion People unaware of their COPD condition can encounter up to 12 barriers, which may combine before obtaining a formal diagnosis. Patients, GPs, pulmonologists and the state health authorities share responsibility for addressing these barriers and enhancing the care pathway.https://bmjopenrespres.bmj.com/content/12/1/e002708.full |
| spellingShingle | Maxime Patout Laurie Fraticelli Maéva Zysman Olivier Le Rouzic Elisabetta Scanferla Clémence Martin Mathieu Delorme Cécilia Nocent-Ejnaini Guillaume Roucoux Lize Kiakouama Maleka Annaig Ozier Yassine Benarbia Lize Kiakouama Olivier Le Rouzic Jean-Paul Vasseur Marie-Agnès Wiss-Laurent Carla Zonca Nissrine Erraji Matthieu Chanard Fabienne Peretz Catherine Beseme Antonio Correira Dos Santos Héla Saïdi Lynda Saïl Twelve barriers to COPD diagnosis in France: a comparative qualitative study BMJ Open Respiratory Research |
| title | Twelve barriers to COPD diagnosis in France: a comparative qualitative study |
| title_full | Twelve barriers to COPD diagnosis in France: a comparative qualitative study |
| title_fullStr | Twelve barriers to COPD diagnosis in France: a comparative qualitative study |
| title_full_unstemmed | Twelve barriers to COPD diagnosis in France: a comparative qualitative study |
| title_short | Twelve barriers to COPD diagnosis in France: a comparative qualitative study |
| title_sort | twelve barriers to copd diagnosis in france a comparative qualitative study |
| url | https://bmjopenrespres.bmj.com/content/12/1/e002708.full |
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