General practitioner views on barriers and facilitators to implementation of the Asthma 3+ Visit Plan

Nicholas A Zwar, Iqbal Hasan, Elizabeth J Comino and Mark F Harris
Med J Aust 2005; 183 (2): 64-67.


Aim: The Asthma 3+ Visit Plan is an initiative to promote organised asthma care in general practice. This study aimed to identify factors associated with uptake of the plan by general practitioners, and their views on barriers and facilitators to implementation of the plan.

Design: Postal survey sent to a random sample of GPs.

Participants and setting: 315 GPs in five Divisions of General Practice in metropolitan Sydney, surveyed sequentially between 1 October 2002 and 31 May 2003.

Outcome measures: Awareness and use of the Asthma 3+ Visit Plan; GP and practice factors associated with use of the plan; and GP views on barriers and facilitators to implementing the plan.

Results: The response rate was 55.7%, and 72.1% of participants were male; participants’ mean age was 50.5 years. Most GPs (91.2%) were aware of the plan and and 44.9% had used it. GP and practice factors associated with use of the plan were use of the six-step Australian Asthma Management Plan, confidence in aspects of asthma care, practice accreditation, sign-up for asthma incentives, and computerisation. Major barriers to implementing the plan were workload/paperwork and administrative complexities. Patient factors that influenced completion of the plan were their concept of the severity of their asthma, compliance with follow-up, and patient attitudes towards asthma care.

Conclusion: The perceived workload and administrative complexity of the asthma incentives are barriers to uptake. Factors relating to the illness rather than social factors are seen as the most important influences on completion of the plan by patients.

  • Nicholas A Zwar1
  • Iqbal Hasan2
  • Elizabeth J Comino3
  • Mark F Harris4

  • 1 General Practice Unit, Fairfield Hospital, Sydney, NSW.
  • 2 School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW.



We acknowedge support from the Primary Health Care Research Network (PHReNet), which is a research-capacity-building activity of the University of New South Wales with funding from the Australian Government Department of Health and Ageing. We also thank PHReNet member GPs Olataga Doorbinnia, Hani Bittar, Judit Gonczi, Peter Edwards, Regina Greenwood, Ven Tan, Phillip Lye, and Huy An, who contributed to survey design and piloting.

Competing interests:

None identified.

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