Motivational training improves self-efficacy but not short-term adherence with asthma self-management: a randomized controlled trial

The Global Initiative for Asthma (GINA) is a network of individuals, organizations, and public health officials that was established to disseminate information about the care of patients with asthma and to improve asthma care. The GINA (“Global Strategy for Asthma Management and Prevention”) report has been updated annually since 2002. Due to new knowledge and therapeutic development in the field, the Swiss Respiratory Society felt the need to provide a new document that is based on both the available literature and the recommendations of the 2016 GINA report. Key new features of the 2016 GINA report include a “new” definition of asthma, underscoring its heterogeneous nature, and the core elements of variable symptoms and variable expiratory airflow limitation; the importance of confirming the diagnosis of asthma in order to minimize both under- and overtreatment; practical tools for the assessment of symptom control and risk factors for adverse outcomes; a comprehensive approach to asthma management that acknowledges the foundational role of inhaled corticosteroid therapy, but also provides a framework for individualizing patient care; an emphasis on maximizing the benefit of available medications by addressing common problems such as incorrect inhaler technique and poor adherence; a continuum of care for worsening asthma, starting with early self-management and progressing to primary care or acute care management; and diagnosis of the asthma/chronic obstructive pulmonary disease overlap syndrome. This document is meant to advice the key stakeholders on the diagnosis and management of asthma and highlights the need to individualize the care of each and every asthmatic patient.

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“…These are best achieved through a partnership between the patient and their health care providers [96].…”

Section: Patient Education and Self-managementmentioning

confidence: 99%

Diagnosis and Management of Asthma – The Swiss Guidelines

et al. 2018

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“…With regard to strategies for goal formulation, 16 articles (26%) focused on strategies for goal formulation using established criteria for effective goal setting [ 12 – 14 , 32 , 34 , 35 , 37 , 48 – 51 , 56 , 58 , 66 , 71 , 78 ]. In these articles, patients were stimulated to set specific, achievable, measurable, realistic, time-bound and behavioral goals (SMART criteria).…”

Section: Resultsmentioning

confidence: 99%

“…Four other articles (7%) applied the same criteria to patients’ action plans, but did not explicitly mention the implementation intention strategy [ 14 , 33 , 38 , 44 ]. The documentation of action plans was reported in 12 articles (21%) [ 29 , 33 , 35 , 36 , 38 , 41 , 43 , 44 , 50 , 54 , 67 , 78 ]. Nuovo et al (2009) used a decision wheel to explore topics to talk about and to produce an action plan, which was then written on the back of the wheel [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…In contrast to goals and action plans, coping plans were only documented in five articles (9%). If documented, they were always written down together with the action plans [ 29 , 35 , 38 , 43 , 44 ]. Four articles (7%) mentioned the use of motivational interviewing and the use of cognitive behavioral principles of problem solving as strategies to set coping plans [ 30 , 40 , 51 , 55 ] (for more explanation see S2 Table ).…”

Section: Resultsmentioning

confidence: 99%

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Disentangling self-management goal setting and action planning: A scoping review

et al. 2017

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IntroductionThe ongoing rise in the numbers of chronically ill people necessitates efforts for effective self-management. Goal setting and action planning are frequently used, as they are thought to support patients in changing their behavior. However, it remains unclear how goal setting and action planning in the context of self-management are defined in the scientific literature. This study aimed to achieve a better understanding of the various definitions used.MethodsA scoping review was conducted, searching PubMed, Cinahl, PsychINFO and Cochrane. Inclusion and exclusion criteria were formulated to ensure the focus on goal setting/action planning and self-management. The literature was updated to December 2015; data selection and charting was done by two reviewers. A qualitative content analysis approach was used.ResultsOut of 9115 retrieved articles, 58 met the inclusion criteria. We created an overview of goal setting phases that were applied (preparation, formulation of goals, formulation of action plan, coping planning and follow-up). Although the phases we found are in accordance with commonly known frameworks for goal setting, it was striking that the majority of studies (n = 39, 67%) did not include all phases. We also prepared an overview of components and strategies for each goal setting phase. Interestingly, few strategies were found for the communication between patients and professionals about goals/action plans. Most studies (n = 35, 60%) focused goal setting on one single disease and on a predefined lifestyle behavior; nearly half of the articles (n = 27, 47%) reported a theoretical framework.DiscussionThe results might provide practical support for developers of interventions. Moreover, our results might encourage professionals to become more aware of the phases of the goal setting process and of strategies emphasizing on patient reflection. However, more research might be useful to examine strategies to facilitate communication about goals/action plans. It might also be worthwhile to develop and evaluate goal setting/action planning strategies for people with different and multiple chronic conditions.

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“…In recent decades, there have been several studies that have explored the use of goal setting in asthma self-management, but results varied. One study indicated that a pharmacist-delivered asthma care program which incorporating goal setting can improve asthma control [21], the other study showed there was no short-term effect on self-management adherence [22]. To our knowledge, no previous review has systemically assessed this body of literature to allow practitioners to evaluate the evidence base of goal setting in asthma management.…”

Section: Introductionmentioning

confidence: 99%

The effect of goal setting in asthma self-management education: A systematic review

Liao

Gao

Peng

2019

International Journal of Nursing Sciences

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Background Asthma self-management education combining with behavior therapy is considered to be more effective. Goal setting is a common behavior change technique used to help patients self-manage their symptoms. However, empirical evidence around its effectiveness on asthma management lacks clarity. Aims To systematically integrate and appraise the evidence for effectiveness of goal setting interventions on asthma outcomes. Methods Databases included CENTRAL, PubMed, EMBASE, CINAHL and Proquest Psychology Database were systematically searched for relevant intervention studies employing goal setting technique as a method in asthma education program for self-management. Characteristic of studies and outcomes in clinical, psychosocial and healthcare utilization outcome were extracted. Results From a total of 2641 citations, 45 full-text articles were assessed for eligibility and 9 studies met the inclusion criteria. Eight studies were randomized controlled trial and one was before-after study. None studies have a high methodological quality. Goal-setting based intervention appeared to improve symptom control, quality of life and self-efficacy in adult patients with asthma. Conclusion This systematic review highlighted the potential of a goal setting technique in the asthma self-management education. However, due to the limitations of the quality and quantity of the included literature, more rigorous studies are needed. In the future, better effective study protocol combining with goal setting approach and other behavior technique is needed to further investigate.

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Motivational training improves self-efficacy but not short-term adherence with asthma self-management: a randomized controlled trial

Abstract: Unspecific self-management training had no short-term effect on self-management adherence in asthma patients. Self-efficacy improved, but it is uncertain whether this translates into better long-term outcomes.

Cited by 20 publications

References 27 publications

Diagnosis and Management of Asthma – The Swiss Guidelines

Diagnosis and Management of Asthma – The Swiss Guidelines

Disentangling self-management goal setting and action planning: A scoping review

The effect of goal setting in asthma self-management education: A systematic review

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