Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study

Korpershoek, Yvonne; Slot, Joyce C. Bruins; Effing, Tanja; Schuurmans, Marieke J.; Trappenburg, Jaap C.A.

doi:10.2147/copd.s138867

Cited by 31 publications

(33 citation statements)

References 39 publications

(62 reference statements)

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“…Total scores, means and standard deviations (SDs) were calculated for all consensus-reaching barriers and facilitators and respondent-suggested techniques in order to ascertain the order of ranking as it was possible that some could have the same percentage of respondent consensus. This follows methods used in previous modified Delphi surveys ( Fisher et al, 2013 ; Gallagher, Bradshaw, & Nattress, 1996 ; Hagen et al, 2008 ; Korpershoek, Bruins Slot, Effing, Schuurmans, & Trappenburg, 2017 ). SPSS v24 was used for analysis carried out on all quantitative data.…”

Section: Methodsmentioning

confidence: 99%

Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey

Fergie

Campbell

Coleman‐Haynes

et al. 2019

Addictive Behaviors Reports

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Introduction Pregnant women can experience barriers and facilitators towards achieving smoking cessation. We sought consensus from smoking cessation practitioners on how influential pre-identified barriers and facilitators can be on pregnant women's smoking behaviour, and how difficult these might be to manage. Suggestions for techniques that could help overcome the barriers or enhance the facilitators were elicited and consensus sought on the appropriateness for their use in practice. Methods Forty-four practitioners who provided cessation support to pregnant women completed a three-round modified Delphi survey. Round one sought consensus on the ‘influence’ and ‘difficulty’ of the barriers and facilitators, and gathered respondents' suggestions on ways to address these. Rounds two and three sought further consensus on the barriers and facilitators and on ‘appropriateness’ of the respondent-suggested techniques. The techniques were coded for behaviour change techniques (BCTs) content using existing taxonomies. Results Barriers and facilitators considered to be the most important mainly related to the influence of significant others and the women's motivation & self-efficacy. Having a supportive partner was considered the most influential, whereas lack of support from partner was the only barrier that reached consensus as being difficult to manage. Barriers relating to social norms were also considered influential, however these received poor coverage of respondent-suggested techniques. Those considered the easiest to address mainly related to aspects of cessation support, including misconceptions surrounding the use of nicotine replacement therapy (NRT). Barriers and facilitators relating to the women's motivation & self-efficacy, such as the want to protect the baby, were also considered as being particularly easy to address. Fifty of the 54 respondent-suggested techniques reached consensus as being appropriate. Those considered the most appropriate ranged from providing support early, giving correct information on NRT, highlighting risks and benefits and reinforcing motivating beliefs. Thirty-three BCTs were identified from the respondent-suggested techniques. ‘Social support (unspecified)’, ‘Tailor interactions appropriately’ and ‘Problem solving’ were the most frequently coded BCTs. Conclusions Involving partners in quit attempts was advocated. Existing support could be potentially improved by establishing appropriate ways to address barriers relating to pregnant smokers' ‘social norms’. In general, providing consistent and motivating support seemed favourable.

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Section: Methodsmentioning

confidence: 99%

Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey

Fergie

Campbell

Coleman‐Haynes

et al. 2019

Addictive Behaviors Reports

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“…However, a more detailed view on these aggregated results shows that still a substantial proportion of COPD patients barely benefits from these kind of interventions. This might be explained by the ‘one size fits all’ and static approach regarding design, intensity and mode of delivery, the sole focus on exacerbation detection and taking action and suboptimal use of interventions [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…To further reduce the impact of exacerbations, a more comprehensive, dynamic and individualized strategy is needed that improves the full spectrum of exacerbation-related self-management behavior [ 11 , 14 , 15 ]. Since previous studies have shown that self-management interventions only improve patient outcomes when changing self-management behavior of COPD patients [ 16 , 17 ], it is important that COPD self-management interventions aim at motivating, engaging and supporting patients to positively adapt their behaviors [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of patients with chronic obstructive pulmonary disease and their health care providers towards using mHealth for self-management of exacerbations: a qualitative study

Korpershoek

Vervoort

Trappenburg

et al. 2018

BMC Health Serv Res

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BackgroundSelf-management of exacerbations in COPD patients is important to reduce exacerbation impact. There is a need for more comprehensive and individualized interventions to improve exacerbation-related self-management behavior. The use of mobile health (mHealth) could help to achieve a wide variety of behavioral goals. Understanding of patients and health care providers perspectives towards using mHealth in promoting self-management will greatly enhance the development of solutions with optimal usability and feasibility. Therefore, the aim of this study was to explore perceptions of COPD patients and their health care providers towards using mHealth for self-management of exacerbations.MethodsA qualitative study using focus group interviews with COPD patients (n = 13) and health care providers (HCPs) (n = 6) was performed to explore perceptions towards using mHealth to support exacerbation-related self-management. Data were analyzed by a thematic analysis.ResultsCOPD patients and HCPs perceived mostly similar benefits and barriers of using mHealth for exacerbation-related self-management. These perceived benefits and barriers seem to be important drivers in the willingness to use mHealth. Both patients and HCPs strengthen the need for a multi-component and tailored mHealth intervention that improves patients’ exacerbation-related self-management by determining their health status and providing adequate information, decision support and feedback on self-management behavior. Most importantly, patients and HCPs considered an mHealth intervention as support to improve self-management and emphasized that it should never replace patients’ own feelings nor undermine their own decisions. In addition, the intervention should be complementary to regular contact with HCPs, as personal contact with a HCP was considered to be very important. To optimize engagement with mHealth, patients should have a positive attitude toward using mHealth and an mHealth intervention should be attractive, rewarding and safe.ConclusionsThis study provided insight into perceptions of COPD patients and their HCPs towards using mHealth for self-management of exacerbations. This study points out that future mHealth interventions should focus on developing self-management skills over time by providing adequate information, decision support and feedback on self-management behavior and that mHealth should complement regular care. To optimize engagement, mHealth interventions should be attractive, rewarding, safe and tailored to the patient needs.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3545-4) contains supplementary material, which is available to authorized users.

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“… 11 – 13 The Delphi method has been used to establish consensus across a range of subject areas, including in the field of public health and clinical trials. 14 , 15 In this study, a three-round Delphi process was used to identify risks that likely occur in clinical trials of CAR T-cell therapy that also have the potential to cause great harm to the safety of the subject ( Figure 1 ). Prior to the Delphi process, a brainstorming session and literature review were conducted to identify the core clinical trial processes that involved potential risks.…”

Section: Methodsmentioning

confidence: 99%

Identification of the risks in CAR T-cell therapy clinical trials in China: a Delphi study

Huo

Ding

et al. 2020

Ther Adv Med Oncol

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Aims: Within the past few years, there has been tremendous growth in clinical trials of chimeric antigen receptor (CAR) T-cell therapies. Unlike those of many small-molecule pharmaceuticals, CAR T-cell therapy clinical trials are fraught with risks due to the use of live cell products. The aim of this study is to reach a consensus with experts on the most relevant set of risks that practically occur in CAR T-cell therapy clinical trials. Methods: A Delphi method of consensus development was used to identify the risks in CAR T-cell therapy clinical trials, comprising three survey rounds. The expert panel consisted of principal investigators, clinical research physicians, members of institutional ethics committees, and Good Clinical Practice managers. Results: Of the 24 experts invited to participate in this Delphi study, 20 participants completed Round 1, Round 2, and Round 3. Finally, consensus (defined as >80% agreement) was achieved for 54 risks relating to CAR T-cell clinical trials. Effective interventions related to these risks are needed to ensure the proper protection of subject health and safety. Conclusion: The Delphi method was successful in gaining a consensus on risks relevant to CAR T-cell clinical trials in a geographically diverse expert association. It is hoped that this work can benefit future risk-based quality management in clinical trials and can potentially promote the better development of CAR T-cell therapy products.

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Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study

Cited by 31 publications

References 39 publications

Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey

Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey

Perceptions of patients with chronic obstructive pulmonary disease and their health care providers towards using mHealth for self-management of exacerbations: a qualitative study

Identification of the risks in CAR T-cell therapy clinical trials in China: a Delphi study

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