scholarly journals Perspectives of patients and healthcare professionals on mHealth for asthma self-management

2017 ◽  
Vol 49 (5) ◽  
pp. 1601966 ◽  
Author(s):  
Andrew J. Simpson ◽  
Persijn J. Honkoop ◽  
Erika Kennington ◽  
Jiska B. Snoeck-Stroband ◽  
Ian Smith ◽  
...  
Keyword(s):  
Asthma Control ◽  
Healthcare Professionals ◽  
Strong Support ◽  
Self Management ◽  
Medical Attention ◽  
Inhaler Technique ◽  
Mixed Methods Design ◽  
Mobile Healthcare ◽  
Asthma Patients

Mobile healthcare (mHealth) has the potential to revolutionise the self-management of long-term medical conditions such as asthma. A user-centred design is integral if mHealth is to be embraced by patients and healthcare professionals.The aim of this study was to determine the perspectives of individuals with asthma and healthcare professionals on the use of mHealth for asthma self-management.We used a sequential exploratory mixed methods design; focus groups informed the development of questionnaires, which were disseminated to individuals with asthma and healthcare professionals.Focus group participants (18 asthma patients and five healthcare professionals) identified 12 potential uses of mHealth. Questionnaire results showed that individuals with asthma (n=186) most frequently requested an mHealth system to monitor asthma over time (72%) and to collect data to present to healthcare teams (70%). In contrast, healthcare professionals (n=63) most frequently selected a system alerting patients to deteriorating asthma control (86%) and advising them when to seek medical attention (87%). Individuals with asthma were less likely than healthcare professionals (p<0.001) to believe that assessing medication adherence and inhaler technique could improve asthma control.Our data provide strong support for mHealth for asthma self-management, but highlight fundamental differences between the perspectives of patients and healthcare professionals.

scholarly journals Goal setting in group programmes for long-term condition self-management support: experiences of patients and healthcare professionals

2019 ◽  
Vol 35 (1) ◽  
pp. 70-86 ◽  
Author(s):  
Stephen Hughes ◽  
Sophie Lewis ◽  
Karen Willis ◽  
Anne Rogers ◽  
Sally Wyke ◽  
...  
Keyword(s):  
Goal Setting ◽  
Healthcare Professionals ◽  
Self Management ◽  
Management Support ◽  
Term Condition

scholarly journals Control of asthma in real life: still a valuable goal?

2015 ◽  
Vol 24 (136) ◽  
pp. 361-369 ◽  
Author(s):  
Andriana I. Papaioannou ◽  
Konstantinos Kostikas ◽  
Eleftherios Zervas ◽  
Lykourgos Kolilekas ◽  
Spiridon Papiris ◽  
...  
Keyword(s):  
Patient Education ◽  
Asthma Control ◽  
Healthcare Professionals ◽  
Real Life ◽  
Adherence To Treatment ◽  
Concerted Action ◽  
Good Patient ◽  
Asthma Patients ◽  
Refractory Asthma

Although studies show that control of asthma can be achieved in the majority of patients, surveys repeatedly show that this is not the case in real life. Important measures to implement in order to achieve asthma control are trained healthcare professionals, a good patient–doctor relationship, patient education, avoidance of exposure to triggers, personalised management and adherence to treatment. These measures help the majority of asthma patients but have not yet been widely implemented and there should be a concerted action for their implementation. Moreover, further and focused research is needed in severe/refractory asthma.

Long-term safety and asthma control with budesonide/ formoterol versus budesonide pressurized metered-dose inhaler in asthma patients

2008 ◽  
Vol 29 (5) ◽  
pp. 499-516 ◽  
Author(s):  
Stephen P. Peters ◽  
Bruce M. Prenner ◽  
William S. Mezzanotte ◽  
Paula Martin ◽  
Christopher D. O'Brien
Keyword(s):  
Asthma Control ◽  
Dose Inhaler ◽  
Metered Dose Inhaler ◽  
Metered Dose ◽  
Asthma Patients ◽  
Pressurized Metered Dose Inhaler

scholarly journals The Impact of Nationally Coordinated Pharmacy-Based Asthma Education Intervention

2001 ◽  
Vol 8 (4) ◽  
pp. 261-265 ◽  
Author(s):  
Shelley Anne Diamond ◽  
Kenneth Ross Chapman
Keyword(s):  
Asthma Control ◽  
Educational Intervention ◽  
Self Management ◽  
Community Pharmacies ◽  
Inhaler Technique ◽  
Short Acting ◽  
Management Behaviour ◽  
Preventive Medication ◽  
The Impact

OBJECTIVE: To assess the impact of a nationally coordinated pharmacy-based educational intervention on self-management behaviour and markers of asthma control in self-referred patients with asthma.DESIGN: An asthma clinic day was set up by a national chain of community pharmacies whereby pharmacists used a structured questionnaire to assess asthma control and self-care among self-referred patients with doctor-diagnosed asthma. In a one-on-one counselling session, each patient's educational needs were identified and the appropriate education offered. A telephone follow-up 30 days later assessed the impact of teaching.SETTING: Community pharmacies across Canada.OUTCOME MEASURES: The follow-up questionnaire quantified the number of wheezing episodes or other symptoms per week, the number of night-time awakenings per week, and the frequency of use of reliever and preventive medications.RESULTS: Of 4080 patients assessed, 22.2% used an inadequate inhaler technique, 16.4% used a short acting beta2-agonist excessively and 21.0% were not using an inhaled corticosteroid daily despite a frequency of symptoms that would suggest that it was needed. Common educational interventions included a review of inhaler technique (41.9%), a recommendation for regular inhaled corticosteroids (31.5%) and a referral to the primary care physician (21.0%). Thirty days after the educational intervention, patients reported significant decreases in the frequency of daytime asthma symptoms, the frequency of nocturnal symptoms and the frequency with which short acting beta2-agonists were used, while reporting significant increases in their use of preventive medication.CONCLUSIONS: A brief assessment and an educational intervention in the community pharmacy can produce significant short term improvements in patient-reported symptom control and appropriate self-management behaviour.

scholarly journals Long-term adherence to inhaled corticosteroids and asthma control in adult-onset asthma

2021 ◽  
Vol 7 (1) ◽  
pp. 00715-2020
Author(s):  
Iida Vähätalo ◽  
Hannu Kankaanranta ◽  
Leena E. Tuomisto ◽  
Onni Niemelä ◽  
Lauri Lehtimäki ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Early Recognition ◽  
Forced Expiratory Volume ◽  
Rapid Decline ◽  
Adult Onset ◽  
Lung Function Decline ◽  
Adult Asthma ◽  
Asthma Patients

BackgroundIn short-term studies, poor adherence to inhaled corticosteroids (ICS) has been associated with worse asthma control, but the association of long-term adherence and disease control remains unclear.ObjectiveTo assess the relationship between 12-year adherence to ICS and asthma control in patients with adult-onset asthma.MethodsAs part of the Seinäjoki Adult Asthma Study, 181 patients with clinically confirmed new-onset adult asthma and regular ICS medication were followed-up for 12 years. Adherence (%) to ICS was assessed individually ((µg dispensed/µg prescribed)×100) during the follow-up. Asthma control was evaluated after 12 years of treatment according to the Global Initiative for Asthma 2010 guideline.ResultsAsthma was controlled in 31% and not controlled (partly controlled or uncontrolled) in 69% of the patients. Patients with not-controlled asthma were more often male, older, nonatopic and used higher doses of ICS than those with controlled disease. The mean±sd 12-year adherence to ICS was 63±38% in patients with controlled asthma and 76±40% in patients with not-controlled disease (p=0.042). Among patients with not-controlled asthma, those with lower 12-year adherence (<80%) had more rapid decline in forced expiratory volume in 1 s (−47 mL·year−1) compared to patients with better adherence (≥80%) (−40 mL·year−1) (p=0.024). In contrast, this relationship was not seen in patients with controlled asthma.ConclusionsIn adult-onset asthma, patients with not-controlled disease showed better 12-year adherence to ICS treatment than those with controlled asthma. In not-controlled disease, adherence <80% was associated with more rapid lung function decline, underscoring the importance of early recognition of such patients in routine clinical practice.

scholarly journals A 1-day visit in a severe asthma centre: effect on asthma control, quality of life and healthcare use

2016 ◽  
Vol 48 (3) ◽  
pp. 726-733 ◽  
Author(s):  
Akke-Nynke van der Meer ◽  
Henk Pasma ◽  
Wilma Kempenaar-Okkema ◽  
Jo-Anneke Pelinck ◽  
Myrte Schutten ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Severe Asthma ◽  
Life Questionnaire ◽  
Healthcare Use ◽  
Uncontrolled Asthma ◽  
Control Quality ◽  
Asthma Patients

Patients with uncontrolled asthma report ongoing symptoms, poor quality-of-life and extensive healthcare use (HCU) and might benefit from management by a specialised severe asthma team. It is unknown whether a one-time evaluation by asthma experts, without long-term supervision by a specialised team, provides favourable outcomes. We evaluated asthma control (Asthma Control Questionnaire; ACQ), quality-of-life (Asthma-related Quality of Life Questionnaire; AQLQ) and HCU before and 1 year after a 1-day visit programme in a severe asthma centre, including a multidisciplinary assessment resulting in a personalised management plan to be implemented by patients own pulmonologists.40 uncontrolled asthma patients completed questionnaires (ACQ, AQLQ, HCU) at baseline, and 6 and 12 months follow-up.ACQ improved from 2.6 (interquartile range 1.7–3.2) to 1.8 (1.2–3.2) (p=0.003) and AQLQ from 4.8 (4.0–5.2) to 5.3 (4.4–6.0) (p<0.001). We found a reduction in patients with ≥2 exacerbations (95% versus 17%; p<0.001), ≥1 emergency room visit (78% versus 37%; p<0.001) and ≥1 hospitalisation (47% versus 10%; p=0.001).Evaluation of uncontrolled asthma patients in a 1-day visit programme in a severe asthma centre resulted in significant improvements in asthma control, quality-of-life and healthcare use after 1 year. This 1-day visit approach seems beneficial for uncontrolled asthma patients and might reduce their dependence on expensive treatment modalities and long-term management in specialised centres.

scholarly journals FACTORS RESTRICT TREATMENT EFFICIENCY IN ASTHMA PATIENTS

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Khaled Hassan
Keyword(s):  
Asthma Control ◽  
Dry Powder Inhaler ◽  
Observational Research ◽  
Inhaler Technique ◽  
Cross Sectional ◽  
Know How ◽  
Modifiable Factors ◽  
Asthma Patients ◽  
Keywords Asthma ◽  
First Time

Background: A number of modifiable factors that contribute to poor asthma control have been identified. We wanted to know how many patients had insufficient therapy, adherence, or major inhaler technique errors, and how they affected asthma control. Methodology: We conducted a cross-sectional multicenter observational research with asthma patients who were referred for the first time from primary to specialized treatment. Adequate prescription according to guidelines, treatment adherence, and illness control were among the data collected. 35.9% of the 1682 patients (age 45-17 years, 64.6 percent men) had insufficient prescriptions, 76.8% had low adherence, and 17 percent had critical inhaler technique errors, with Easyhaler users making significantly fewer critical errors than other dry powder inhaler users (10.3 versus 18.4%; p 0.05). Inadequate prescription (OR: 3.65), non-adherence to therapy (OR: 1.8), and inhaler abuse were all linked to poor asthma control (OR: 3.03). A greater number of risk variables were linked to a greater likelihood of having poorly managed asthma. Keywords: Asthma, interdental cleaning, elderly, prevention, periodontal disease, caries.

scholarly journals Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions

2021 ◽  
pp. bjsports-2021-104281
Author(s):  
Hamish Reid ◽  
Ashley Jane Ridout ◽  
Simone Annabella Tomaz ◽  
Paul Kelly ◽  
Natasha Jones
Keyword(s):  
Physical Activity ◽  
Adverse Events ◽  
Perceived Risk ◽  
Healthcare Professionals ◽  
Medical Attention ◽  
Activity Levels ◽  
Long Term Conditions ◽  
Starting Point ◽  
Physical Activity Levels

IntroductionThe benefits of physical activity for people living with long-term conditions (LTCs) are well established. However, the risks of physical activity are less well documented. The fear of exacerbating symptoms and causing adverse events is a persuasive barrier to physical activity in this population.This work aimed to agree clear statements for use by healthcare professionals about medical risks of physical activity for people living with LTCs through expert consensus. These statements addressed the following questions: (1) Is increasing physical activity safe for people living with one or more LTC? (2) Are the symptoms and clinical syndromes associated with common LTCs aggravated in the short or long term by increasing physical activity levels? (3) What specific risks should healthcare professionals consider when advising symptomatic people with one or more LTCs to increase their physical activity levels?MethodsStatements were developed in a multistage process, guided by the Appraisal of Guidelines for Research and Evaluation tool. A patient and clinician involvement process, a rapid literature review and a steering group workshop informed the development of draft symptom and syndrome-based statements. We then tested and refined the draft statements and supporting evidence using a three-stage modified online Delphi study, incorporating a multidisciplinary expert panel with a broad range of clinical specialties.ResultsTwenty-eight experts completed the Delphi process. All statements achieved consensus with a final agreement between 88.5%–96.5%. Five ‘impact statements’ conclude that (1) for people living with LTCs, the benefits of physical activity far outweigh the risks, (2) despite the risks being very low, perceived risk is high, (3) person-centred conversations are essential for addressing perceived risk, (4) everybody has their own starting point and (5) people should stop and seek medical attention if they experience a dramatic increase in symptoms. In addition, eight symptom/syndrome-based statements discuss specific risks for musculoskeletal pain, fatigue, shortness of breath, cardiac chest pain, palpitations, dysglycaemia, cognitive impairment and falls and frailty.ConclusionClear, consistent messaging on risk across healthcare will improve people living with LTCs confidence to be physically active. Addressing the fear of adverse events on an individual level will help healthcare professionals affect meaningful behavioural change in day-to-day practice. Evidence does not support routine preparticipation medical clearance for people with stable LTCs if they build up gradually from their current level. The need for medical guidance, as opposed to clearance, should be determined by individuals with specific concerns about active symptoms. As part of a system-wide approach, consistent messaging from healthcare professionals around risk will also help reduce cross-sector barriers to engagement for this population.

scholarly journals A collaborative approach to exercise provision for people with Parkinson’s – a feasibility and acceptability study of the PDConnect programme

2020 ◽  
Vol 2 ◽  
pp. 29
Author(s):  
Julie Jones ◽  
Lyndsay Alexander ◽  
Elizabeth Hancock ◽  
Kay Cooper
Keyword(s):  
Neuroprotective Effect ◽  
Well Being ◽  
Self Management ◽  
Care Group ◽  
Mixed Methods Design ◽  
Structured Interviews ◽  
Exercise Participation ◽  
Rate Of Decline ◽  
Non Motor Symptoms

Background: Exercise has been shown to be beneficial for people with Parkinson’s (PwP), limiting the rate of decline of motor and non-motor symptoms, with emerging evidence associating exercise with a neuroprotective effect. Current exercise provision is time-limited, and delivered in the absence of strategies to support long-term adherence to exercise. With a growing Parkinson’s population, there is a need to develop long-term sustainable approaches to exercise delivery. The primary aim of this study is to assess the feasibility and acceptability of a multicomponent intervention (PDConnect) aimed at promoting physical activity, and self-management for PwP. Methods: A convergent fixed parallel mixed methods design study will be undertaken. The study aims to recruit 30 PwP, who will be randomly allocated into two groups: (i) the usual care group will receive physiotherapy once a week for six weeks delivered via Microsoft Teams. (ii) The PDConnect group will receive physiotherapy once a week for six weeks which combines exercise, education and behaviour change interventions delivered by NHS Parkinson’s specialist physiotherapists via Microsoft Teams. This will be followed by 12 weekly sessions of group exercise delivered on Microsoft Teams by fitness instructors specially trained in Parkinson’s. Participants will be then contacted by the fitness instructors once per month for three months by video conferencing to support exercise engagement. Primary feasibility data will be collected during the study, with acceptability assessed via semi-structured interviews at the end. Secondary outcomes encompassing motor, non-motor and health and well-being measures will be assessed at baseline, at six, 18, and 30 weeks. Discussion: This pilot study will establish whether PDConnect is feasible and acceptable to PwP. This will provide a platform for a larger evaluation to assess the effectiveness of PDConnect at increasing exercise participation and self-management within the Parkinson’s Community. Trial registration: Registered on ISRCTN (ISRCTN11672329, 4th June 2020).

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