{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:52:13Z","timestamp":1791345133817,"version":"4.3.1"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"unspecified","delay-in-days":279,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1463423626101807_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In 2020 the Irish Health Service Executive (HSE) shifted chronic disease management (CDM), including COPD and asthma, into primary care via a funded CDM programme. An Enhanced Community Care (ECC) initiative established local clinical specialist teams (CSTs) providing spirometry, nurse-led clinics and pulmonary rehabilitation to support primary care practitioners (PCPs). We explored early PCP experience, diagnostic access, and confidence, to identify improvement priorities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101807_as2\">\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>We sought to evaluate PCPs experiences with the implementation of Ireland\u2019s CDM and ECC programmes for COPD and asthma, focusing on diagnostic access, clinical confidence and priorities for service improvement and professional development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101807_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A semi-structured survey was distributed nationally through PCP faculty meetings, mailing lists and messaging groups. Single- and multi-choice items, Likert scales (1\u201310) reported as median and interquartile range (IQR), and ranked options quantified satisfaction, access and educational needs; free-text responses underwent thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101807_as4\">\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>One-hundred-12 PCPs responded (62% urban; 65% &gt;10 years in practice). Most practices (97%) had adopted CDM and 87% perceived better patient outcomes arising from this, yet only 33% reported a major change in their own practice. Integrated-care hubs were rated good\u2013excellent by 87% and superior to hospital outpatient care by 84%, but limited diagnostics (52%), delayed two-way communication (45%) and inadequate specialist support (50%) persisted. Self-reported confidence in guideline knowledge was modest (asthma 7 (IQR 6\u20137); COPD 7 (IQR 6\u20137)) and very low for interpreting pulmonary-function tests and prescribing pulmonary rehabilitation (3 (IQR 2\u20135) and 5 (IQR 4\u20136) respectively). Priority topics for continuing-professional-development were: differentiating asthma from COPD, inhaler device choice and PFT interpretation.<\/jats:p>\n                    <jats:p>Irish PCPs value the CDM\/ECC model but highlight implementation gaps. Targeted CPD, faster digital feedback and decision-support tools are needed, alongside longitudinal evaluation against health-service benchmarks and sustainability frameworks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1463423626101807","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:48:36Z","timestamp":1791344916000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing respiratory integrated care models in Ireland: insights from PCP feedback on the early days of integrated chronic disease management pathways"],"prefix":"10.1017","volume":"27","author":[{"given":"Helen","family":"O\u2019Brien","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05m7pjf47","id-type":"ROR","asserted-by":"publisher"}],"name":"University College Dublin School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"McCarthy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/029tkqm80","id-type":"ROR","asserted-by":"publisher"}],"name":"St Vincent\u2019s University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-6804","authenticated-orcid":false,"given":"Jayleigh","family":"Lim","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/029tkqm80","id-type":"ROR","asserted-by":"publisher"}],"name":"St Vincent\u2019s University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5500-2009","authenticated-orcid":false,"given":"Orla","family":"O\u2019Carroll","sequence":"additional","affiliation":[{"name":"Tralee General Hospital: University Hospital Kerry"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Tallaght Hospital: Tallaght University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead M.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Galway University Hospitals"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4241-8718","authenticated-orcid":false,"given":"Alessandro N.","family":"Franciosi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05m7pjf47","id-type":"ROR","asserted-by":"publisher"}],"name":"University College Dublin School of Medicine"},{"id":[{"id":"https:\/\/ror.org\/029tkqm80","id-type":"ROR","asserted-by":"publisher"}],"name":"St Vincent\u2019s University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"S1463423626101807_ref4","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2020.0064"},{"key":"S1463423626101807_ref6","doi-asserted-by":"publisher","DOI":"10.1080\/13814788.2024.2430521"},{"key":"S1463423626101807_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2018.05.006"},{"key":"S1463423626101807_ref11","unstructured":"GINA (2025) Global Strategy for Asthma Management and Prevention. Available at www.ginasthma.org (accessed 1 June 2025)."},{"key":"S1463423626101807_ref24","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4848-9"},{"key":"S1463423626101807_ref22","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.11656"},{"key":"S1463423626101807_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-016-0442-y"},{"key":"S1463423626101807_ref25","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.113662"},{"key":"S1463423626101807_ref27","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046875"},{"key":"S1463423626101807_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4437"},{"key":"S1463423626101807_ref15","doi-asserted-by":"publisher","DOI":"10.1038\/npjpcrm.2014.32"},{"key":"S1463423626101807_ref1","unstructured":"(NICE) NIfHaCE (2024) Asthma: Diagnosis and monitoring of asthma in adults, children and young people. London: NICE. Report No.: NG245."},{"key":"S1463423626101807_ref9","first-page":"CD012652","article-title":"Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care","volume":"5","author":"Cross","year":"2022","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"S1463423626101807_ref26","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"S1463423626101807_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2023-220435"},{"key":"S1463423626101807_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2014-003712"},{"key":"S1463423626101807_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.8.831"},{"key":"S1463423626101807_ref3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023"},{"key":"S1463423626101807_ref12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202312-2248ED"},{"key":"S1463423626101807_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19627"},{"key":"S1463423626101807_ref14","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/142.4.832"},{"key":"S1463423626101807_ref20","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01585-2021"},{"key":"S1463423626101807_ref10","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6.3.e34"},{"key":"S1463423626101807_ref8","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.2025.211.Abstracts.A4069"},{"key":"S1463423626101807_ref13","unstructured":"HSE (2025) The Third Report of the Structured Chronic Disease Management Treatment Programme in General Practice. Available at https:\/\/wwwhseie\/eng\/services\/publications\/primary\/third-chronic-disease-reportpdf (accessed 1 June 2025)."},{"key":"S1463423626101807_ref5","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202308-1436OC"},{"key":"S1463423626101807_ref16","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2025.0009"}],"container-title":["Primary Health Care Research &amp; Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1463423626101807","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:48:38Z","timestamp":1791344918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1463423626101807\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":27,"alternative-id":["S1463423626101807"],"URL":"https:\/\/doi.org\/10.1017\/s1463423626101807","relation":{},"ISSN":["1463-4236","1477-1128"],"issn-type":[{"value":"1463-4236","type":"print"},{"value":"1477-1128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e123"}}