Table 4.

Advantages and disadvantages of different settings, patients’ and clinicians’ view

Setting		Patients	Health professionals
General practice	Yes	To improve patient education
		Some patients do not have a pneumologist (not available or wanted)
		For awareness among GPs of patients’ needs (What does the patient really need?)
		To identify patients who should be seen by a pneumologist
			Most frequent and close patient contact
			Time should be taken to clarify unmet needs
	No	Missing expertise of GPs
		No time in everyday practice
		Lack of willingness of GPs
Pneumological practice	Yes	High expertise of pneumologists
			Frequent patient contact
			More effective conversation management
			Inquire about need/optimize therapy
			To improve patient education
			To control the success of the treatment
	No	No time in everyday practice (structured practice procedures, High patient volume, economic pressure)
		Some patients do not have a pneumologist (not available or wanted)
Disease Management Program (DMP)	Yes	Identification and evaluation of health care needs (Which needs exist before, which could be met afterwards?)
		Provides sufficient time (staff and patients have more time, group meetings save time)
		During training (group discussion)
		Short two-way conversation with physician
	No		Too structured (no room and time for flexibility)
			Redundant (mentioned needs are addressed anyway)
Pulmonary rehabilitation	Yes	Provides content frame (education and practice, pulmonary rehabilitation staff get more information about patients)
		Provides time frame (staff and patients have more time)
		Identification and evaluation of health care needs (Which needs exist before, which could be met afterwards?)
		Especially if diagnosis is recent
		High expertise of training staff
	No	Usually too late in medical history
		No willingness among staff
			Redundant (mentioned needs are addressed anyway)