Effect of a theory-driven educational-intervention for improving adherence to inhalation therapy in patients with chronic obstructive pulmonary disease: a pilot study
Refereed conference paper presented and published in conference proceedings


Full Text

Other information
AbstractBackground:
Patients with chronic obstructive pulmonary disease (COPD) show poor adherence to inhalation therapy, thereby reducing the treatment effect. Information-motivation-behavioral (IMB) model is recommended as a theoretical framework for adherence intervention but the use of this model in patients with COPD has not been adequately evaluated.
Objectives:
The objectives were to evaluate the effect of an IMB model-based educational intervention on adherence to inhalation frequency and inhalation techniques.
Method:
This study was a randomized controlled trial. The subjects were older people with COPD recruited from a specialist outpatient clinic of a public hospital in Hong Kong and randomized into intervention and control groups after collection of informed written consents and baseline data. The intervention was an IMB model-based educational intervention which consisted of a one-hour face-to-face educational session and two telephone follow up sessions on the second and fourth weeks. The control was usual care. The intervention was conducted on the day of subject randomization. The adherence to the inhalation frequency was calculated by using the ratio of the number of doses taken to the number of doses prescribed. The adherence to inhalation techniques were assessed by the checklists designed by the National Asthma Council Australia in 2008. Data were collected before and six weeks after randomization. Regarding data analysis, a generalized estimating equations model was used to assess the differential change of inhalation frequency and inhalation techniques.
Results:
The final sample consisted of 15 intervention and 15 control subjects with a mean age of 75.7 years (SD = 4.8). There were not any significant differences in baseline socio-demographic and clinical characteristics between the intervention and control groups. No significant difference was found between the two groups in terms of medication adherence (p = 0.388) and inhalation techniques (p = 0.557) at baseline. Although the GEE model did not show a significant difference in the change of inhalation adherence across the two study time points between the two groups (B = 18.19, 95% CI: [-4.72, 41.10], p = 0.120), it showed a statistically significant difference in the change of inhalation techniques across the two study time points between the two groups (B = 15.57, 95% CI: 5.73, 25.42], p = 0.002) indicating that the intervention group had significantly greater improvements in their inhalation techniques compared with the control group.
Conclusion:
The IMB model-based educational intervention could improve COPD patients’ adherence to inhalation techniques but could not demonstrate a statistically significant effect on medication adherence.
Acceptance Date17/04/2018
All Author(s) ListKa-Wing TO, Iris Fung-Kam LEE
Name of ConferenceHong Kong College of Gerontology Nursing Annual Scientific Meeting 2018: Building a Sustainable Quality Gerontological Healthcare
Start Date of Conference26/05/2018
End Date of Conference26/05/2018
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Proceedings TitleHong Kong College of Gerontology Nursing Annual Scientific Meeting 2018
Year2018
Month5
Day1
Volume Number28
PublisherHong Kong College of Gerontology Nursing
Place of PublicationHong Kong
Pages6 - 6
LanguagesEnglish-United States

Last updated on 2018-20-11 at 13:00