Lay versus professional motivation for asthma treatment: a cross-sectional, qualitative study in a single Glasgow general practice

OBJECTIVE: Our aim was to identify the factors which motivate patient self-management in asthma and to compare the results with the factors which appear to have motivated the content of the British Thoracic Society (BTS) clinical guidelines for chronic asthma in adults. METHOD: We conducted a cross-sectional, qualitative survey of asthma patients from a single general practice list in Glasgow, Scotland. Twenty-three adult asthma patients on at least step 2 of the BTS guidelines were selected from the practice asthma register. RESULTS: Only seven of the 23 subjects had asthma treatment goals. People with asthma are motivated by the effect of the illness on self-image, the experience of symptoms, the value of life experiences affected, the perceived consequences of asthma, their acceptance of the diagnosis and their attitude towards medication. Asthma is largely viewed as unproblematic. CONCLUSIONS: The BTS guidelines appear to be motivated by a desire to heighten professional awareness about the disease. Patient goals and preferences for asthma treatment are largely unrecognized by the guidelines. A concordant model of disease management, involving the explicit acknowledgement of patient goals by professionals, alongside their own goals for treatment, may improve adherence to treatment perceived by patients as relevant and achievable.