Why don't patients attend the asthma clinic?

Gruffydd-Jones, Kevin; Nicholson, Isla; Best, Lynda; Connell, Elizabeth B.

doi:10.1038/pcrj.1999.14

Cited by 5 publications

(3 citation statements)

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“…Second, those who do acknowledge they have symptoms and limitation of activities accept them as unavoidable consequences of having asthma. 3) Patients reasons for not attending asthma reviews revolve around feelings that their asthma is not serious enough [ 9 ]. Asthma Action plans are underused for several reasons [ 31 ]: i) Differences in beliefs and attitudes between health care professionals and people with asthma.…”

Section: Resultsmentioning

confidence: 99%

Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study

Morrison

Mair

Chaudhuri

et al. 2015

BMC Med Inform Decis Mak

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BackgroundAround 300 million people worldwide have asthma and prevalence is increasing. Self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. We aimed to develop an evidence based, theory informed, online resource to support self-management in adults with asthma, called ‘Living well with Asthma’, as part of the RAISIN (Randomized Trial of an Asthma Internet Self-Management Intervention) study.MethodsWe developed Living well with Asthma in two phases.Phase 1: A low fidelity prototype (paper-based) version of the website was developed iteratively through input from a multidisciplinary expert panel, empirical evidence from the literature, and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process.Phase 2: The paper-based designs were converted to a website through an iterative user centred process. Adults with asthma (n = 10) took part in think aloud studies, discussing the paper based version, then the web-based version. Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Think aloud transcripts were also thematically analysed, further informing resource development.ResultsThe website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback on the contents of the resource was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties.ConclusionsOur multifaceted approach to online intervention development underpinned by theory, using evidence from the literature, co-designed with end users and a multidisciplinary panel has resulted in a resource which end users find relevant to their needs and easy to use. Living well with Asthma is undergoing evaluation within a randomized controlled trial.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-015-0177-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study

Morrison

Mair

Chaudhuri

et al. 2015

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

show abstract

“…Sample size and statistical methods —An 80% power, at the 5% significance level (two tailed test), of detecting a 20% difference in the proportion of patients reviewed from 30% to 50% required 206 patients 3. A difference of 0.5 in the Juniper scores (SD 0.78) required 180 patients 14.…”

Section: Methodsmentioning

confidence: 99%

“…Despite proactive asthma care in general practice, only about a third of people with asthma attend for annual review. 3 4 Non-attenders, however, may have considerable morbidity. 3 4 It is therefore a good idea to explore innovative, patient centred ways of providing care 5…”

Section: Introductionmentioning

confidence: 99%

Accessibility, acceptability, and effectiveness in primary care of routine telephone review of asthma: pragmatic, randomised controlled trial

Pinnock

2003

BMJ

120

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Objective To determine whether routine review by telephone of patients with asthma improves access and is a good alternative to face to face reviews in general practices. Design Pragmatic, randomised controlled trial. Setting Four general practices in England. Participants 278 adults who had not been reviewed in the previous 11 months. Intervention Participants were randomised to either telephone review or face to face consultation with the asthma nurse. Main outcome measures Primary outcome measures were the proportion of participants who were reviewed within three months of randomisation and disease specific quality of life, as measured by the Juniper mini asthma quality of life questionnaire. Secondary outcome measures included the validated "short Q" asthma morbidity score, nursing care satisfaction questionnaire score, and length of consultation. Results Of 137 people randomised to telephone consultation, 101 (74%) were reviewed, compared with 68 reviewed (48%) of the 141 people in the surgery group, a difference of 26% (95% confidence interval 14% to 37%; P < 0.001; number needed to treat 3.8). Three months after randomisation the two groups did not differ in the Juniper score (risk difference − 0.07 (95% confidence interval − 0.40 to 0.27) or in satisfaction with the consultation (risk difference − 0.07 ( − 0.27 to 0.13)). Telephone consultations were on average 10 minutes shorter than reviews held in the surgery (mean difference 10.7 minutes (12.6 to 8.8; P < 0.001)). Conclusions Compared with face to face consultations in the surgery, telephone consultations enable more people with asthma to be reviewed, without clinical disadvantage or loss of satisfaction. A shorter duration means that telephone consultations are likely to be an efficient option in primary care for routine review of asthma.

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Telephone or surgery asthma reviews? Preferences of participants in a primary care randomised controlled trial

Pinnock

Madden

Snellgrove

et al. 2005

Primary Care Respiratory Journal

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Summary 263 participants completing a randomised controlled trial comparing telephone vs. face-to-face asthma consultations were asked about preferences for future reviews. Qualitative analysis of data from 209 respondents identified divergent views. Clear opinions were expressed about the respective roles of the two modes of consulting; telephone consultations were considered convenient for reviewing 'well controlled' asthma, whereas face-to-face consultations were perceived as allowing in-depth assessment of problems in those with more symptomatic asthma. Practices may consider offering patients the choice of a telephone or face-to-face review.

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Why don't patients attend the asthma clinic?

Cited by 5 publications

References 0 publications

Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study

Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study

Accessibility, acceptability, and effectiveness in primary care of routine telephone review of asthma: pragmatic, randomised controlled trial

Telephone or surgery asthma reviews? Preferences of participants in a primary care randomised controlled trial

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