Insight into Older Peoples’ Healthcare Experiences with Managing COPD, Asthma, and Asthma–COPD Overlap

Abstract

Objective. The aim of this study was to explore older peoples’ experiences of asthma or COPD with reference to their journey in the healthcare system. Methods. We recruited older patients with a confirmed diagnosis of asthma or COPD and invited them to participate in a qualitative interview. Interviews were conducted with 21 participants. A line-by-line analysis of the interviews was performed and they were coded for common themes. Results. From the data, six main themes emerged, these were; “limits to being”, “being with or without a diagnosis”, “not being heard or recognized”, “expectation, fears, and hopes”, “to medicate or not: the underuse, abuse, and misuse”, and “needing to understand more”. The findings of these interviews provide an important understanding of the behaviors and healthcare needs of older people with asthma and COPD. Older patients’ adherence patterns, desire for person-centeredness, and involvement in shared decisions as well as desire for increased objective assessment are described. Conclusions. These findings provide an important understanding of the behaviors and healthcare needs of older people with asthma and COPD, an area that has not been well defined. The knowledge gained about older patients’ desire for person—centeredness and involvement in shared decisions, as well as desire for increased objective assessment is essential in improving care.

• Aging
• Asthma
• COPD
• Older people
• Person-centeredness
• Qualitative

Acknowledgments

The authors thank and acknowledge the participants for giving their time and sharing their experiences. They also acknowledge Dianne Goeman for her advice regarding Nvivo analysis.

Declaration of Interest

Dr Vanessa McDonald is supported by the National Health and Medical Research Council (NHMRC) Centre for Respiratory and Sleep Medicine and the CRC for asthma and airways. She has been reimbursed for participation in symposia funded by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Novartis. She has participated in studies funded by GlaxoSmithKline and Novartis.

Professor Isabel Higgins has no conflict of interest to declare.

Professor Peter Gibson holds an NHMRC Practitioner Fellowship. He has been reimbursed for participation in symposia funded by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Novartis. He has participated in studies funded by Pharmaxis and GlaxoSmithKline.