An intervention programme using the ASE-model aimed at enhancing adherence in adolescents with asthma

Abstract

A randomised controlled trial, involving 112 adolescents with asthma, and a 2-year follow-up was conducted to assess the impact of an intervention programme aimed at enhancing adherence to asthma medication. This programme had a duration of 1 year and consisted of an experimental group which received usual care from a paediatrician, but additionally attended individual and group sessions with an asthma nurse, and a control group which received usual care only. The programme aimed at enhancing adherence by stimulating a positive attitude, increasing feelings of social support, and enhancing self-efficacy. At baseline, and after 12-month (T1) and 24-month (T2) follow-up, the participants filled in questionnaires which were based on the concepts of the ASE-model. Adherence was assessed by self-report (range: 1-10) at the same points in time. After 12 months, 97 adolescents (87%) were available for follow-up, decreasing to 86 adolescents (77%) after 24 months. No statistically significant differences were found between the control and the experimental group, except for one. At T2, self-reported adherence appeared to be statistically significantly higher in the experimental group. In conclusion, there seems to have been no substantial effect of the intervention programme.

Interventions to Enhance Patient Adherence to Medication Prescriptions

“…Van Es et al 48 tested the effectiveness of a 1-year intervention involving individual instruction and review of asthma control from a pediatrician, individual and group educational sessions with an asthma nurse, and written summaries of group sessions. At 12 months, there were no significant improvements in adherence to prophylactic medications or in clinical outcomes.…”

A Systematic Review of Adherence-Enhancing Interventions in Adolescents Taking Long-term Medicines

“…This latter study attempted to facilitate adherence to medicines by improving access to care [52]. Only four of the 16 interventions studies described educational material based on a named (formal) training program [38,48,49,54]. Education was delivered to participants through verbal discussions (group sessions, seminars, lectures, telephone) [38 -40,43-45,48,49,54], a health fair [40], provision of written material [39,42,48,49,51,53,54], videotapes [39,42], drawings [54], and was not clarified in four studies [41,46,47,50].…”

“…In 10 studies, the main intervention delivery site was the patient's usual clinic [38,39,[42][43][44][47][48][49]51,54]. Alternative delivery sites, used alone or in addition to the clinic, included the patients' homes [41,43,45,46,50], schools [52], and in four cases, various venues including community facilities were considered [40,41,43,46].…”

“…One intervention was based on text messaging [53]. Three studies delivered the intervention to peer groups [38,39,54] rather than individual adolescents.…”

“…Allocation concealment was reported in four studies [48,50,53,54]. Incomplete information regarding study withdrawals or dropouts was evident in nine studies [39,40,42,44 -49].…”