Thunderstorm asthma epidemic – management challenges experienced by general practice clinics

Abstract

Objectives

To understand the challenges faced by general practice (GP) services in terms of personnel, materials, secondary support services, and discharge and communication obstacles during the thunderstorm asthma (TA) epidemic in 2016.

Methods

Qualitative study using semi-structured interviews and focus groups between September and October 2017. Participants were general practitioners (GPs), practice nurses, and administrative staff working on the TA epidemic days in the northern region of Melbourne, Australia.

Results

18 participants contributed to the study from six clinic sites. Both daytime and evening clinics experienced a surge in respiratory patient presentations. After-hours clinics were inundated with asthma patients during the night of the thunderstorm. Consistent themes emerged about the challenges encountered by participants the most significant being limitation of medication, equipment, space, and personnel. The extraordinary influx of patients necessitated participants innovate solutions including recycling equipment, procuring medications from hospitals and community pharmacies, triage, altering management strategies and extending clinic hours. Participants were limited by the paucity of information from local services during the TA epidemic.

Conclusion

This study supports the view that GP services made a substantial contribution to the emergency response on the evening of the TA epidemic that occurred in Melbourne in 2016. Demands on resources were considerable during and after the epidemic yet GP staff showed great resilience increasing clinic surge capacity. Our findings indicate significant barriers at an organizational level including resource limitations, inadequate operational information, and the absence of timely communication channels that impaired the response of GP services during a TA event.

Keywords:

• Thunderstorm asthma
• general practice
• primary health care
• epidemic

Acknowledgments

The authors would like to acknowledge general practitioners, practice nurses and administrative staff who very generously gave their time to participate in this research project.

The paper or any part of the data contained in it, has not been previously published, and is not currently being considered for publication by any other journal. All the authors have seen and approved the final copy of this work and ensured the integrity of it. The authors agree to assign copyright should the paper is accepted for publication.

Declaration of interests

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.