Qualitative-analysis-on-interprofessional-collaboration-in-the-management-of-paediatric-bronchial-asthma-challenges-and-suggestions-for-improvement

Abstract

Introduction: Multi-disciplinary healthcare providers need to move beyond task-based responsibility towards a more collaborative approach. Chronic childhood diseases such as bronchial asthma demands effective multidisciplinary team collaboration to improve patient care. Objective: We aimed to examine the interprofessional collaboration between physicians and pharmacists in the management of paediatric bronchial asthm, to explore the views and experiences of both pharmacists and physicians on the important aspects of Paediatric Respiratory Medication Therapy Adherence Clinic (PRMTAC) and patient-centeredness, and to identify barriers against interprofessional shared decision-making in the management of paediatrics bronchial asthma. Method: The study involved a face-to-face interview involving paediatric medical officers and pharmacists involved with PRMTAC. The semi-structured interview included four pharmacists and three paediatric resident physicians from Hospital Tuanku Fauziah, Perlis, Malaysia. A full audio recording was used for detailed data retrieval and verbatim transcription. The session was deemed completed once all the probed questions had reached a thematic conclusion. Result and Discussion: Three main themes emerged: (I) The relevance and necessity of PRMTAC service to complement paediatric outpatient bronchial asthma management, (II) the lack of communication between pharmacist-physician in outpatient bronchial asthma management, and (III) recommendations for a combined clinic in the management of outpatient paediatric bronchial asthma. PRMTAC services were rated as highly relevant in the management of outpatient bronchial asthma among all study respondents, irrespective of profession. The detailed assessment of medication compliance and technical demonstration provided by PRMTAC services were deemed fundamental in holistic patient care. The current clinical scenario demonstrates that the pharmacist and paediatric medical team work independently and in parallel, rather than collaboratively. Such workflow challenges in-tandem decision-making with regards to patient-focused medication. The lack of interaction also impedes sharing of ideas and new knowledge that could benefit both parties in relation to the management of outpatient bronchial asthma. A combined clinic was unanimously suggested to remedy this. Conclusion: Proper planning with regard to allocation of support systems and mobilisation of human resources needs to be instituted to realise the implementation of a nationwide combined clinic in the management of paediatric bronchial asthma.