Development of patient centered management of asthma and COPD in primary care

The ageing of the population leads to an increased number of patients with chronic conditions. Examples of common chronic conditions are asthma and COPD, these are respiratory illnesses mostly treated by the general practitioner. In this thesis options for the development of patient centered care for primary care asthma and COPD patients were evaluated. A good example of patient centered care in the north of the Netherlands is the asthma COPD service. This service was initiated in 2007, based on a cooperation between general practitioners and pulmonologists in the province of Groningen. Patients with respiratory complaints could be referred by their GP to the service for assessment. This assessment takes place close to where the patient lives. A local pulmonologists assesses the results through the internet and provides the general practitioner with a diagnosis and treatment advice. The GP remains in charge and decides how to proceed. The service exists more than 10 years and has assessed more than 18,000 patients in this way. This thesis showed that this method is feasible and effective. Patient centered care can be optimized by taking into account other diseases when treating asthma or COPD. Moreover optimal patient centered treatment of chronic conditions require optimal self-management. Providing access for patients to reliable and personal medical information for example through a patient web portal can enhance self-management. In short, patient centered care has the potential to optimize health care for primary care asthma and COPD patients.