Managing preschool wheeze: a qualitative study of parents' views and experiences.

Objective: The aim of this study was to explore parents' views and experiences of managing preschool wheeze, including opinions on the use of investigations to inform treatment pathways.

Design: Purposive sampling was used to recruit 16 participants from 14 families across England and Wales. Qualitative data were collected via semi-structured interviews with parents of children aged 1-5 years with preschool wheeze, conducted on Microsoft (MS) Teams. Data were transcribed and analysed using thematic analysis, facilitated by NVivo software package.

Results: Analysis generated four themes: (1) pathway to diagnosis, (2) medication management, (3) living with preschool wheeze and (4) improving preschool wheeze healthcare. Findings suggest a negative impact of preschool wheeze on families' lives, including high levels of worry and limiting capacity for work and travel. Barriers to effective management of preschool wheeze included inconsistent terminologies and diagnostic uncertainty alongside limited education and management support. Other barriers included parental concerns about medications, delayed investigations and challenges with accessing specialist care. Parents were in favour of performing investigations to guide treatment pathways.

Conclusion: Parents' views highlight the problem of diagnosing and treating preschool wheeze at multiple system levels. To improve management and ensure that services for children with preschool wheeze are effective, there is an urgent need for consistent terminology, a unified approach to guide investigations and treatments and for upskilling healthcare professionals in primary and secondary care.