“Don't get me wrong, I think case finding is okay” Exploring healthcare professionals' perspectives on target case-finding for COPD

Background: COPD is a major cause of disability and death in the UK. It is estimated that around 3 million people have COPD, 2 million of whom are undiagnosed. Targeted case-finding run within primary care practices may enhance diagnosis; but currently little is known about views of healthcare professionals (HCPs) working in this area. Aim: To understand the perspectives of HCPs working in primary care on case-finding for COPD. Methods: A convenience sample of 36 HCPs (12 GPs, 14 nurses and 10 practice managers) from 34 UK GP practices participated in semi-structured telephone interviews, which were audio-recorded and transcribed verbatim. Interviews explored the desirability and acceptability of case-finding, and perceived barriers and facilitators. Data were analysed using Framework Approach and multiple coders Results: Most practices approached case-finding opportunistically. Targeted case-finding was reportedly acceptable by most practices if additional resources and support were available. Patient engagement with targeted case-finding, and the cost implications associated with identifying more patients with COPD were perceived as the main barriers. Financial incentives, support from specialist clinicians, and comprehensive guidance for running targeted case-finding were all viewed as facilitators to HCP involvement. Conclusion: Providing cost and resource solutions, training and education opportunities for HCPs on COPD will facilitate targeted case-finding of COPD in primary care practices. Research is needed to explore patient perspectives on COPD and targeted case-finding, and identify ways to optimise public engagement with case-finding initiatives.