Education Program Improves Clinician Ability to Support Asthma, COPD Patients

Malin Axelsson, MD, MSc

Educational interventions and programs can increase healthcare providers’ readiness to support patients with asthma, allergy, or chronic obstructive pulmonary disease (COPD). Such programs, which may consist of events like lectures and workshops, can help providers address various medication adherence issues for each patient.

Previous literature has shown medication adherence to be problematic among these patients. Low adherence can diminish chances of good disease control and improved health-related quality of life.

A team, led by Malin Axelsson, MD, MSc, Department of Care Science, Malmo University, Sweden, designed an educational intervention with the aim of strengthening healthcare professionals’ ability and preparedness to support patients who have asthma, allergy, and COPD. The focus of the intervention was on adherence and professional communication, and included nurses and healthcare professionals working at asthma/COPD clinics in primary healthcare centers.

The intervention lasted 3.5 hours and was conducted across 2 training days. Furthermore, the content in the program was developed using evidence from scientific literature on adherence as well as the overall clinical experiences of the investigators.

An adherence to medication lecture was given to the attendants, which included topics such as occurrence of poor adherence, adherence behavior, influencing behavior, influencing factors, personality traits, treatment and treatment goals, etc.

Following the initial lecture, attendants also participated in a professional communication lecture, which covered areas related to active listening, providing feedback, and how to address nonadherence, among others.

And finally, the program concluded with workshops that involved attendants in fictitious patient cases, planning of person-centered adherence support, as well as oral presentations.

The patient cases presented by the investigators all demonstrated various adherence issues—ranging from skepticism of medication to patient resistance. Together, the participants developed individualized strategies for supporting such patients.

Throughout the program, the investigators collected qualitative data from the workshops and the participants’ reasoning through the patient cases. Quantitative data was collected through questionnaires, which were completed by the participants’ prior to and following the intervention.

Thus, a total of 70 participants were involved in the intervention. Of the total, 94.3% were nurses, and 84.3% had undergone education in the field of asthma, allergy and COPD.

Further, 55.1% had worked at a certified asthma/COPD clinic.

As many as 48.6% strongly indicated that they followed up patients’ adherence to the medication at each reception visit.

Additionally. 91.4% disagreed with the sentiment that it was not their duty to follow up how patients take their medication. A majority of participants agreed it was necessary to follow up with patient adherence to medication at each visit (77.1%) as well as to check patient inhalation tecnique (82.6%).

Prior to the intervention, the mean score (on a 1-5 scale) for participant knowledge of adherence was 3.95—versus 4.18 post-intervention (P = .001).

Similarly, the knowledge of how to measure patients’ adherence was strengthened overall—pre-intervention, 3.02 vs post-intervention, 3.54 (P = .001).

The ability or confidence to communicate effectively about these issues was heightened from 3.92 before intervention to 4.13 following intervention (P = .011).

Thus, participants’ overall readiness to support patients for better adherence had strengthened from 3.78 to 4.13 (P – 0.001).

Axelsson and colleagues noted a few limitations, including lack of diversity in types of healthcare professionals as well as the inability to fully generalize the study’s results and participants’ experiences. They also noted the potential for implementing a control group for future studies.

However, they nonetheless underscored the importance and implications of their findings.

"Hopefully, the outcome of our study will inspire nurses and other healthcare professionals at asthma/COPD clinics to include adherence planning for patients, which in turn will improve adherence to medication treatment,” they wrote.

The study, “Effect of an Educational Program on Healthcare Professionals’ Readiness to Support Patients with Asthma, Allergies, and Chronic Obstructive Lung Disease for Improved Medication Adherence,” was published online in Nursing Research and Practice.