Management of asthma in primary care in the changing context of the COVID-19 pandemic: a qualitative longitudinal study with patients

Background: The COVID-19 pandemic dramatically affected asthma monitoring in primary care. Yet, patients’ views and experiences of managing their asthma and seeking help from primary care during the pandemic have not been explored. Aim: To investigate patients’ experiences of asthma management in the community during the COVID-19 pandemic. Design and setting: A qualitative longitudinal study using semi-structured interviews with asthma patients usually managed in primary care. Method: Interviews were audio recorded, transcribed and analysed using inductive temporal thematic analysis and trajectory approach. Results: Forty-six interviews were conducted with 18 asthma patients over eight months that covered contrasting stages of the pandemic. Patients felt less vulnerable as the pandemic subsided but the process of making sense of risk was dynamic and influenced by multiple factors. Patients relied on self-management strategies but felt that routine asthma reviews should still have been conducted during the COVID-19 pandemic and highlighted limited opportunities to discuss their asthma with health care professionals. Patients with well controlled symptoms felt that remote reviews were largely satisfactory but still felt that face to face reviews were necessary for certain aspects such as physical examination and patient-led discussion of sensitive or broader issues associated with asthma including mental health. Conclusions: The dynamic nature of patients’ perception of risk throughout the pandemic highlighted the need for a greater clarity regarding patients’ personal risk. Having opportunity to discuss their asthma is important to patients even during periods when access to face to face consultations in primary care is more restricted than usual.