A Real-World Pilot of the Feasibility and Acceptability of Direct to Consumer Inhaler Education Intervention Among a Humana COPD Population

Abstract

Intro: Respiratory inhalers deliver the mainstay treatments to control and relieve symptoms for individuals with COPD. While these medications are highly efficacious, their real-world effectiveness is limited by poor adherence and/or inhaler technique. Through a partnership with a national insurance company's value based insurance design (VBID) program for patients with COPD we piloted a direct-to-patient 'virtual teach-to-goal' (V-TTG) educational intervention conjunction with pharmacist-based phone calls to determine feasibility and acceptability. Methods: We aimed to enroll n=10 patients with COPD in this pilot study. The intervention consisted of an email with information about how to access the educational modules and one conversation with pharmacists. Pharmacists conducted a brief qualitative interview with patients at the end of their conversation. We obtained adherence to the module using the module platform analytics. This program received quality improvement determination at the University of Chicago. Results: Ten patients were enrolled in October 2020. Of the 10 patients, 9 (90%) completed the pharmacist call, 8 (80%) completed the module, and 8 (80%) completed the post-intervention survey. One of the two that did not complete the module started but did not complete due to it being "too much trouble" and so did not have survey feedback and the other one did not start the module or talk with the pharmacist. Of those completing the module (8/10), 6 used their smartphone and 2 used a computer. The majority of patients thought the module was easy to use (6/8) and would recommend this intervention to a friend (6/8); all patients thought the video demonstration provided value (8/8). The value patients noted included that it is helpful to "have a refresher" (n=2), learned something new (n=4): "learned to wait between sprays if needed twice (n=1)," "learned about spacer (n=2)," and learned I was breathing in too quickly (n=2)," the video length was appropriate (short): "all that people can retain," gained confidence (n=1): "I am more confident in using my inhaler now." In addition to positive feedback, patients had constructive feedback including text was small when using a smart phone (n=2), could not return to change an answer (n=1), and a question was confusing (n=1). Discussion: A direct to consumer/patient inhaler training module was both feasible and acceptable among the majority of patients enrolled in a pilot VBID intervention. Larger studies are needed to determine whether widespread uptake could impact patient outcomes and healthcare utilization.