Enhancing Chronic Respiratory Disease Management in Rural India: Evaluating the Feasibility of Spirometry/Peak Flow Meter Integration in Primary Care

Research Question: What is the feasibility and acceptability of integrating spirometry and peak flow meters into the routine practice of primary care physicians in rural India for the effective diagnosis and management of Chronic Respiratory Diseases (CRD). Background: Chronic respiratory symptoms are prevalent in developing countries, but often go undiagnosed and poorly managed. In rural India, primary care physicians are pivotal in addressing health needs. Previous RESPIRE research has revealed varied knowledge levels and identified challenges (such as limited resources and poor patient compliance) among GPs managing asthma and COPD, underscoring the need for improved training and diagnostic accessibility. Methodology: This mixed-methods pre-post intervention study targets private sector primary care physicians in our Community Health Research Unit (KEMHRC). Baseline data on CRD management knowledge, attitudes, and practices, and the use (or not) of spirometry/peak flow meters, will be collected. Pulmonologist-led interventions will include chronic respiratory illness awareness and hands-on training in spirometry/peak flow meters. Six-months post-intervention we will assess changes in knowledge, attitudes, and practices. In-depth interviews with up to 20 primary care physicians will explore facilitators and barriers to incorporating these tools into clinical practice. Questions to Discuss: 1. How can we reliably assess local GP knowledge and practices at baseline and after 6-months? 2. Spirometry is the gold standard test, but would it be better in a low resource setting to focus on peak flows, or hand-held FEV1/FVC meters? 3. We can teach knowledge and skills, but how can we motivate GPs to change their practice?