What can we learn from speaking to asthma patients more than once? The power of qualitative longitudinal design in primary care research.

BACKGROUND: Qualitative Longitudinal Research (QLR) has a long tradition in a variety of social science disciplines and is increasingly used in applied healthcare research. QLR can provide insights into the nature, causes and consequences of change (or its absence). However, its use in primary care research is limited. AIM: Drawing on a recent study looking at experiences of asthma patients in the context of the COVID-19 pandemic over time, we highlight the opportunities in using longitudinal qualitative methods in primary care research. METHOD: We conducted a qualitative longitudinal study using semi-structured interviews with patients with asthma from four GP practices across diverse regions including Thames Valley, Greater Manchester, Yorkshire, and North West Coast. The interviews were audio-recorded, transcribed, and analysed using inductive temporal thematic analysis and a trajectory approach. RESULTS: Forty-six interviews conducted with 18 patients over an 8-month period of the COVID-19 pandemic highlighted that patients felt less vulnerable as the pandemic subsided, but the process of making sense of risk was dynamic and influenced by multiple factors. Patients relied on self-management strategies, and with time, highlighted that they had limited opportunities to discuss their asthma with health professionals. As time progressed, face-to-face reviews appeared more necessary for certain aspects, such as physical examination and patient-led discussions of sensitive or broader issues associated with asthma, including mental health. CONCLUSION: QLR has much to offer primary care research allowing exploration of views and experiences of a variety of participants over time and following them through important transitions.

Tackling antimicrobial resistance in the community

Antimicrobial resistance is an important societal issue. Making sure patients in the community get the right antibiotic at the right time is important to preserve our existing antibiotics. In this article, we discuss some of the interventions that have shown promise in optimising antibiotic-prescribing and use in the community, both in, and outside the consultation room. We outline the factors needed to evaluate the cost-effectiveness of such interventions in the context of antimicrobial resistance, and highlight the caveats and challenges for policymakers.