A qualitative study of the impact of the COVID-19 pandemic on healthcare access and service delivery for people living with chronic obstructive pulmonary disease and asthma

Background: Incidence of chronic obstructive pulmonary disease and asthma diagnosis were lower during and after the Coronavirus disease 2019 pandemic in Alberta, Canada. However, it is unknown whether incidence was actually lower or if the pandemic created circumstances where patients did not seek care. As such, the objective of the current study was to explore the impact of COVID-19 on patient and clinician experiences of healthcare access and delivery. Methods: The study was conducted between October 2023 and July 2024. We used Interpretive Description, a qualitative approach with the end-goal of informing clinical decisions. Analysis was informed by Braun and Clarke’s six phases of reflexive thematic analysis. Results: We completed thirteen interviews. Two key themes were generated: 1) The pandemic impacted care-seeking behaviours; and 2) A time and place for virtual and in-person care. Clinicians discussed how access to entry points to the health system were impacted by the pandemic and highlighted how strategies to manage health and stressors impacted symptoms and subsequent care-seeking behaviours. Participants highlighted the positives of virtual and in-person care with the consensus that both are valuable. Conclusion: Future use of virtual care modalities should include a visual element at minimum and prioritize the therapeutic relationship.