1. The PRIME Study Dr. Komalkirti Apte
Perceived need for chronic Respiratory dIsease ManagErs:
A pilot study
Dr. Komalkirti Apte
Ms. Madhuragauri Shevade, Ms. Sapna Madas, Dr. Sundeep Salvi.
Chest Research Foundation, Pune

2. The need for this study Population of > 1.2 billion
2nd most populous
7th largest (3.3 million  km2 )
multilingual
widely diverse
Population of > 1.2 billion
Healthcare is largely self funded and catered to for by 1.5 million doctors (856,085 doctors trained in modern medicine and 712,121 doctors trained in alternative medicine)
Population > 1.2 bn

3. No of patients seen per day
STATE-WISE DISTRIBUTION OF NUMBER OF PATIENTS SEEN BY EACH DOCTOR / DAY
>30
25 – 30
<20
No of patients seen per day
40 million patients visit some doctor (non-specialist) every day in India
Salvi S, Apte K et al.
Lancet Global Health Dec 2015

4. Appointment based system of patient consultation?

5. The need for this study Chronic Respiratory complaints
Acute Respiratory complaints
Clinical history
Examination
Diagnostic tests
Medical management
Counseling
Patient training on medication use
All other body system complaints
40 million patients
1.5 million doctors
~ 8 – 9 minutes per patient
Prevalence (in %)
Salvi S, Apte K et al .
Lancet Global Health 2015

6. Research Question ??
Is there a perceived need for additional skilled assistance in the management of patients suffering from chronic respiratory diseases?
Is there a possibility of development of a second tier of skilled and qualified healthcare professionals who will bridge the gap between patients of chronic respiratory diseases and the limited number of skilled doctors?

7. Research Methodology Study Population 7442 doctors Pulmonologists 125
Intended sample size:
N = 500
125 Pulmonologists
125 Intensivists
125 Pediatricians
125 GPs
7442 doctors
Pulmonologists
125
Intensivists
125
Pediatricians
125
Pulmonologists
10.02%
(746)
Intensivists
28.78%
(2142)
Pediatricians
17.15%
(1276)
GPs
44.05%
(3278)
GPs
125

8. Research Tool

9. Research Tool

10. 84 doctors participated in the study
Data Management
7442 invites
Nov 2014
Consent
I agree to participate
7395 doctors did not respond
7395 re-invites
Consent
I agree to participate
47 doctors
7391 doctors did not respond
4 doctors
84 doctors participated in the study
Consent
I agree to participate
7391 Telephonic calls
3852 numbers had discontinued service
33 doctors

11. 84 doctors participated in the study
Transferred to Epi Info Software
Generated into Microsoft Access
84 doctors participated in the study
Transferred to SPSS
Data Analysis

12. Results Response rate Ps 125 Ps 27.38% (23) 3.08% Is 41.67% (35) Is
1.63%
Peds
8.33%
(7)
Peds
125
0.55%
GPs
125
GPs
22.62%
(19)
0.58%

13. Workload of chronic respiratory diseases in the participating doctor practices
GPs
Intensivists
6 – 12 mins/pt
5 – 15 mins/pt
Acute diseases TB
Allergic Rhinitis
COPD
Asthma
Others
Pulmonologists
Pediatricians
4 – 14 mins/pt
5 – 15 mins/pt

14. Assistance of manpower in management of chronic respiratory disease patients
No assistance
Temporary and unqualified assistance
Trained assistance
% of assistance available

15. Need for assistance in managing patients of chronic respiratory diseases
% of doctors responses

16. Required competencies suggested for skilled manpower assistance
GPs
Intensivists
Pulmonologists
Pediatricians

17. Conclusion Heavy patient load Insufficient time
Poorly trained / temporary assistance
Need to develop a second tier of skilled and qualified healthcare professionals

18. Impact of the study