scholarly journals Barriers to smoking cessation: a qualitative study from the perspective of primary care in Malaysia

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025491 ◽  
Author(s):  
Kooi-Yau Chean ◽  
Lee Gan Goh ◽  
Kah-Weng Liew ◽  
Chia-Chia Tan ◽  
Xin-Ling Choi ◽  
...  
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Grounded Theory ◽  
Qualitative Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Time Frame ◽  
The Body ◽  
Theory Method ◽  
Grounded Theory Method

ObjectivesThis qualitative study aims to construct a model of the barriers to smoking cessation in the primary care setting.DesignIndividual in-depth, semistructured interviews were audio-taped, then verbatim transcribed and translated when necessary. The data were first independently coded and then collectively discussed for emergent themes using the Straussian grounded theory method.Participants and settingFifty-seven current smokers were recruited from a previous smoking related study carried out in a primary care setting in Malaysia. Current smokers with at least one failed quit attempts were included.ResultsA five-theme model emerged from this grounded theory method. (1) Personal and lifestyle factors: participants were unable to resist the temptation to smoke; (2) Nicotine addiction: withdrawal symptoms could not be overcome; (3) Social cultural norms: participants identified accepting cigarettes from friends as a token of friendship to be problematic; (4) Misconception: perception among smokers that ability to quit was solely based on one’s ability to achieve mind control, and perception that stopping smoking will harm the body and (5) Failed assisted smoking cessation: smoking cessation services were not felt to be user-friendly and were poorly understood. The themes were organised into five concentric circles based on time frame: those actionable in the short term (themes 1 and 2) and the long term (themes 3, 4, 5).ConclusionsFive themes of specific beliefs and practices prevented smokers from quitting. Clinicians need to work on these barriers, which can be guided by the recommended time frames to help patients to succeed in smoking cessation.

scholarly journals Why a successful task substitution in glaucoma care could not be transferred from a hospital setting to a primary care setting: a qualitative study

2013 ◽  
Vol 8 (1) ◽  
Author(s):  
Kim M Holtzer-Goor ◽  
Thomas Plochg ◽  
Hans G Lemij ◽  
Esther van Sprundel ◽  
Marc A Koopmanschap ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Hospital Setting

scholarly journals Impact of a Pharmacist-Provided Spirometry Service on Access to Results in a Primary Care Setting

2018 ◽  
Vol 9 ◽  
pp. 215013271875921 ◽  
Author(s):  
Lisa A. Mueller ◽  
Alexa Sevin Valentino ◽  
Aaron D. Clark ◽  
Junan Li
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Time Frame ◽  
Primary Objective ◽  
Completion Rate ◽  
Primary Care Settings ◽  
Significant Difference ◽  
Referral Completion ◽  
Time Frames

Objectives: The primary objective of this study was to determine the effect of a pharmacist-provided spirometry service within a federally qualified health center on the percentage of spirometry referrals completed with results reviewed by the ordering provider. Secondary objectives evaluated differences between internal and external referrals, medication recommendations made by the pharmacist, and revenue brought in by the service. Methods: Chart reviews were completed to determine the referral completion rates between patients who received a spirometry referral before (December 2014–September 2015) and after (January 2016–October 2016) the implementation of the pharmacy-provided spirometry service. Chart reviews were also used to determine the number and completion rate among referrals for internal and external services in the postimplementation time frame. Chart reviews also assessed medication recommendations made by the pharmacist. Results: The results demonstrate an increase in referral completion rate from 38.1% to 47.0% ( P = .08) between the pre- and postimplementation time frames. In the postimplementation time frame, there was a statistically significant difference in the percentage of referrals completed between in-house referrals and external referrals (70.0% and 40.9%, respectively, P = .0004). Comparing clinics with and without the spirometry service, there was a statistically significant difference in the total number of spirometry referrals (1.13% and 0.59%, respectively, P < .0001) and the percent of referrals completed (0.55% and 0.27%, respectively, P = .0002). Conclusion: The results suggest that offering spirometry within the primary care setting helps to increase the rate of completed spirometry tests with results available to the primary care provider. Additionally, the results show that there is an increased completion rate in patients who receive an internal spirometry referral, which may be due to reduced barriers in obtaining this testing. Overall, these results demonstrate that providing spirometry in the primary care setting helps to increase spirometry results obtained and could be beneficial in other primary care settings.

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