Exploring stakeholders' attitudes and perspectives on COPD screening in China - A qualitative study

Introduction: Screening for COPD is recommended in China, however, it is not universally implemented. Aim: To explore stakeholders' attitudes and perspectives on screening for COPD and the barriers and facilitators to implement COPD screening in primary care settings in China. Method: A qualitative study. Data were collected from medical facilities’ managers, medical professions and COPD patients using focus groups or in-depth interviews in two Chinese cities. Interviews were audio-recorded and transcribed, thematic framework analysis was used for the qualitative data. Results: From November 28th to December 31st , 2023, totally 19 participants from 10 facilities (8 at Inner Mongolia and 2 at Shenzhen) were interviewed, including 10 facility managers, 8 General Practitioners or county physicians and 1 newly diagnosed COPD patient. Two Focus groups were conducted in Inner Mongolia and 5 individual in-depth interviews were conducted in Shenzhen. 2 of 8 facilities at Inner Mongolia and 2 at Shenzhen implemented COPD screening. Six overarching themes were identified: screening for COPD was necessary in China; lack of awareness of COPD and COPD screening, unwillingness to be screened for fear of being diagnosed with a disease, medical professions’ low willingness to screen for COPD and insufficient trained technicians were main barriers; incentives, policy orientations and competent medical professions were facilitators to COPD screening implementation. Conclusion: COPD screening in primary care was not yet universal in China. An accessible implementation mechanism for COPD screening was needed to help promote COPD screening in clinical practice in primary care. Funding: 2023 International Primary Care Respiratory Group (IPCRG) grants