The Integrated Care of Asthma in Switzerland (INCAS) Study: Changes in Asthma Control and Perception of Health Care through Asthma Education

Abstract

Background: Despite great efforts in establishing optimal asthma management, asthma may remain uncontrolled. To effectively manage chronic diseases, such as asthma, it is important to train patients in self-management skills. Objectives: The aim of this study was to assess the potential benefit of standardised asthma education in Switzerland for asthma control and patients' perception of received asthma care and of self-management support. Methods: For this multicentre longitudinal controlled study, asthma patients were recruited in Switzerland. The Asthma Control Test (ACT) was used to assess asthma control. The Patient Assessment of Chronic Illness Care questionnaire (PACIC 5A) was applied to evaluate received health-care services and self-management support. Patients were offered the possibility to attend asthma education sessions conducted by the Swiss Lung League and Swiss Allergy Centre. After 1 year, attenders and non-attenders completed the questionnaires again. Changes in ACT and PACIC 5A scores were analysed using dependent t tests. Results: Overall, 223 patients with asthma were investigated (mean age 43 ± 12 years, 38% male, 13% current smokers, 29% ex-smokers). Sixty-one (27%) patients attended education sessions. Both groups had improved asthma control at follow-up (attenders: t(56) = -3.2, r = 0.4 [medium effect size], p = 0.002; non-attenders: t(141) = -2.6, r = 0.2 [small effect size], p = 0.010). Attenders improved in PACIC and 5A sum scores (t(50) = -3.6, r = 0.5 [medium effect size], p = 0.001). Conclusions: A comprehensive self-management asthma education programme in Switzerland improved asthma control and patients' perception of received asthma care and of self-management support. Professionals should motivate patients to attend asthma education in order to become active partners in managing their disease.

Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial

“…Thus, 40% of the asthma patients indicated that their disease was not well-or poorly controlled while 30% of the COPD patients stated a high or very high impact of the ailment on their health status. These results are comparable to prior studies by Guénette et al, where 48% of the patients reported uncontrolled asthma [20] and by Dürr et al where 34% of the patients had uncontrolled asthma at baseline [21]. The mean CAT sum score was 16.7 in COPD patients at baseline, indicating a medium impact on health statusa value also observed in the PHARMACOP study, which examined the effectiveness of a pharmaceutical care programme in patients suffering from COPD [22].…”

“…Not holding breath for about 5 s after inhalation a 6 (7) 1 (4) 1 developments in disease and therapy. This is particularly important in order to ensure that patients are continuously and actively involved in the treatment procedure [21]. Furthermore, these findings reconfirm the recommendation by the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines to regularly re-evaluate the correct device application to prevent faulty long-term device use [5,28].…”

Prescription and use of inhaled medication in patients with asthma and COPD: Baseline-data of an adherence-Intervention-study

“…This is particularly important in order to ensure that patients are continuously and actively involved in the treatment procedure [27]. Furthermore, these findings reconfirm the recommendation by the GINA and GOLD guidelines to regularly re-evaluate the correct device application to prevent faulty long-term device use [2,18].…”

Psychometric properties of the Patient Assessment of Chronic Illness Care measure (PACIC-5A) among patients with obesity

“…While the structure as proposed by Glasgow et al was confirmed, no detailed results of the factor analysis were shown in this study [10]. Other previous studies used the PACIC-5A to evaluate chronic care, especially for diabetic and asthmatic patients [20–23]. However, little is known about the underlying structure of the instrument so far.…”

“…In contrast, Glasgow et al revealed a comparably higher 5A summary score of 3.2 in a sample of diabetic patients and Rosemann et al showed a value of 2.5 among patients with osteoarthritis [10, 18]. In turn, one recently published study that used PACIC-5A among asthmatic patients in Switzerland revealed lower values of 2.0 for overall PACIC score and 5A summary score at baseline [23]. The lower scores in the present study were accompanied by high floor effects.…”