Challenges of the Pandemic Response in Primary Care during Pre-Vaccination Period: A Qualitative Study.

Shane Thomas,Dan Engelhard,Leon Piterman,Mark Ashworth,Marina Kunin

doi:10.1186/s13584-015-0028-5

Abstract

BackgroundDuring the 2009/A/H1N1 pandemic, the main burden of the patient management fell on primary care physicians (PCPs), and they were the principal implementers of pandemic policies. Broad involvement of PCPs in the pandemic response offered an excellent opportunity to investigate the challenges that they encountered.ObjectiveTo examine challenges faced by PCPs as they implemented pandemic policies in Australia, Israel and England before the 2009/A/H1N1 pandemic vaccine became available.MethodsThis is a qualitative descriptive study that employed in-depth semi-structured interviews with 65 PCPs from Australia, Israel and England. The data were analysed thematically to provide a detailed account of the themes.ResultsChallenges in three fields of the pandemic response were identified. (i) Consultation of patients was challenged by the high flow of patients, sick and worried-well, the necessity to provide personalised information about the disease during consultations, and unfamiliar antiviral treatment. (ii) Performance of public health responsibilities was complicated in regards to patient segregation and introduction of personal protection measures. (iii) Communication with the health authorities was inefficient, with no established route to provide feedback about the pandemic policies.ConclusionsThe experience of the 2009/A/H1N1 pandemic highlighted the centrality of primary care in the pandemic response. Despite intensive pre-pandemic planning, numerous barriers for implementation of the pandemic policies in primary care were identified. Investigation of three different approaches for involvement of PCPs in the pandemic management showed that none of these approaches worked smoothly.

Highlights

During the 2009/A/H1N1 pandemic, the main burden of the patient management fell on primary care physicians (PCPs), and they were the principal implementers of pandemic policies
The experience of the 2009/A/H1N1 pandemic highlighted the centrality of primary care in the pandemic response
Investigation of three different approaches for involvement of PCPs in the pandemic management showed that none of these approaches worked smoothly

Summary

Introduction

During the 2009/A/H1N1 pandemic, the main burden of the patient management fell on primary care physicians (PCPs), and they were the principal implementers of pandemic policies. Three approaches to involvement of PCPs in the pandemic response When the World Health Organization declared a “significant increase in risk of a pandemic”[9], each of the three countries employed strategies to delay the appearance of the disease and to contain its spread. During this containment phase, a range of policy measures, such as active epidemiological investigation, isolation of cases and school closure, were used. Each of the three selected countries employed different strategies for the involvement of PCPs during this period [10]

Results

Discussion

Conclusion