title: Patients' perspectives on the impact of a new COPD diagnosis in the face of multimorbidity: a qualitative study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD), a major cause of morbidity and mortality worldwide, often occurs in the presence of comorbidities, which may influence experience and management of the disease. No prior research seems to have gained perspectives of newly diagnosed primary care COPD patients in the context of multimorbidity.
  
  
  OBJECTIVE
  This qualitative study aimed to explore the impact of a new diagnosis of COPD in the context of multimorbidity and also sought to gain a better understanding of how patients react to the diagnosis and incorporate it into their lives.
  
  
  METHODS
  Participants were identified from a cohort of primary care patients with multimorbidity recently diagnosed with COPD. Data was collected via semi-structured interviews from nine male and eight female participants. Thematic analysis was performed and the data interpreted from a constructivist perspective.
  
  
  RESULTS
  Five core themes regarding COPD were induced: (i) reaction to diagnosis, (ii) impact on function and health behaviour, (iii) factors influencing self-management capacity, (iv) healthcare utilisation and (v) interplay of comorbidities. Most participants had difficulty recognising the importance of COPD and its long-term implications. For many, the salience of another chronic condition outweighed COPD. Self-management capacity and utilisation of healthcare services were challenged by low prioritisation of COPD among other comorbidities.
  
  
  CONCLUSIONS
  This study provides an insight into how primary care patients feel about being diagnosed with COPD, as well as their prioritisation of the disease in the context of multimorbidity. It highlights the need for tailored education and personalised management incorporating patients' perspectives in primary care.
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, NSW, Australia.
authors.forename: Sameera
authors.initials: S
authors.lastname: Ansari
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, NSW, Australia.
authors.forename: Hassan
authors.initials: H
authors.lastname: Hosseinzadeh
authors.affiliation: 1] School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, NSW, Australia [2] Clinical and Rehabilitation Sciences, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dennis
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, NSW, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Zwar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis*; D036301:Qualitative Research; D011795:Surveys and Questionnaires