A maximum variation sample of healthcare professionals who cared

A maximum variation sample of healthcare professionals who cared for adult patients learn more with bronchiectasis participated in mixed discipline focus groups. Snowballing recruitment was initiated through key contacts in existing professional networks. Recruitment was supported by the Northern Ireland Clinical Research Network. Focus groups were led by two facilitators using an iterative topic guide of relevant open-ended questions exploring healthcare professionals’ views barriers to treatment adherence and strategies to improve adherence in bronchiectasis. All focus groups were audio-recorded and transcribed verbatim. Transcripts were imported

into NVivo® 10 software. Broad themes were identified using thematic analysis. Office for Research Ethics Northern Ireland approval was obtained. To date, 34 participants (8 physiotherapists, 16 nurses, 5 doctors, 2 hospital pharmacists, Akt inhibitor 1 community pharmacist, 1 psychologist, 1 practice nurse) have participated

in 6 focus groups (4–8 participants per group). Thirty participants were female (88%), were qualified a mean (SD) 19 (8) years, 18/34 (53%) worked in a hospital setting, 12/34 (35%) worked in a community setting and 4/34 (12%) worked in both the hospital and community setting. Three main themes were identified: patient motivators and barriers to adherence, healthcare barriers and motivators to adherence Roflumilast and strategies to improve adherence. Patient-specific motivators included taking responsibility for their own health, experiencing benefits from treatment and being knowledgeable about disease and treatments. Most reported that burdensome treatments, patients’ lack of knowledge and misplaced beliefs about treatments could act as barriers to adherence. For healthcare professionals, lack of time with patients and lack of a clear patient pathway between primary and secondary care were recognised as important healthcare barriers to managing adherence. Furthermore, some healthcare professionals

did not feel confident discussing adherence with patients due to concerns about jeopardising the patient-clinician relationship. In contrast, other healthcare professionals reported using a non-judgemental, honest approach to build rapport and facilitate adherence discussions. Healthcare professionals thought that a bronchiectasis-specific intervention led by a multidisciplinary team and using multiple components, including self-management and education could be useful in improving adherence and would be feasible within routine care. Healthcare professionals recognised that they would require specific training in adherence management as part of any developed intervention. This is the first study in which views about adherence to treatment in bronchiectasis have been obtained from a broad sample of experienced healthcare professionals.

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