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Eck S, Hapfelmeier A, Linde K, Schultz K, Gensichen J, Sanftenberg L, Kühlein T, Stark S, Gágyor I, Kretzschmann C, Schneider A. Effectiveness of an online education program for asthma patients in general practice: study protocol for a cluster randomized controlled trial. BMC Pulm Med 2022; 22:457. [PMID: 36456965 PMCID: PMC9713723 DOI: 10.1186/s12890-022-02217-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/27/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Asthma education programs (AEPs) have been shown to increase quality of life and reduce emergency treatments and hospital admissions. Despite the proven benefits, only a minority of asthma patients attend such programs. To increase the number of educated patients, an online education program (electronic AEP, eAEP) for asthma patients has been developed. The present study aims to investigate the effectiveness of the eAEP in terms of asthma knowledge, asthma control and emergency treatments in general practice settings. METHODS This is a cluster randomized controlled trial including 100 patients with bronchial asthma from 20 general practices in Bavaria, Germany. General practices will be randomly assigned to either the intervention or control group. Patients in the intervention group will receive access to the eAEP and instructions to complete this program within two weeks. Patients in the control group will receive usual care including a referral to face-to-face AEP (fAEP) by a certified primary care physician or a pulmonologist according to guideline recommendations. Furthermore, patients of both the intervention and control groups will be invited to a follow-up consultation in their general practice after completion of the eAEP and fAEP (three weeks and twelve weeks after study inclusion, respectively) to discuss any open issues. Outcomes for both groups will be assessed at baseline (t0), after two weeks (t1), three months (t2) and six months (t3). The primary outcome is the comparison of asthma knowledge gain between intervention and control groups after completion of the eAEP (two weeks after study inclusion) and fAEP (twelve weeks after study inclusion), respectively. Secondary outcomes include asthma control, frequency of emergency treatments, patient autonomy as well as attitudes towards asthma medication. DISCUSSION The results of the present trial will provide knowledge about the effectiveness of an online education program for asthma patients compared to usual care in primary care. TRIAL REGISTRATION German Clinical Trials Register (DRKS), DRKS00028805 . Registered 22 April 2022.
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Affiliation(s)
- Stefanie Eck
- grid.6936.a0000000123222966Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich (TUM), Orleansstraße 47, 81667 Munich, Germany
| | - Alexander Hapfelmeier
- grid.6936.a0000000123222966Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich (TUM), Orleansstraße 47, 81667 Munich, Germany ,grid.6936.a0000000123222966Institute for AI and Informatics in Medicine, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Klaus Linde
- grid.6936.a0000000123222966Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich (TUM), Orleansstraße 47, 81667 Munich, Germany
| | - Konrad Schultz
- Clinic Bad Reichenhall, Center for Rehabilitation, Pneumology and Orthopedics, Bad Reichenhall, Germany
| | - Jochen Gensichen
- grid.5252.00000 0004 1936 973XInstitute of General Practice and Family Medicine, Ludwig-Maximilians-Universität in Munich (LMU Munich), Munich, Germany
| | - Linda Sanftenberg
- grid.5252.00000 0004 1936 973XInstitute of General Practice and Family Medicine, Ludwig-Maximilians-Universität in Munich (LMU Munich), Munich, Germany
| | - Thomas Kühlein
- grid.5330.50000 0001 2107 3311Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stefanie Stark
- grid.5330.50000 0001 2107 3311Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ildikó Gágyor
- grid.411760.50000 0001 1378 7891Department of General Practice, Universitätsklinikum Würzburg (UKW), Würzburg, Germany
| | - Christian Kretzschmann
- grid.411760.50000 0001 1378 7891Department of General Practice, Universitätsklinikum Würzburg (UKW), Würzburg, Germany
| | - Antonius Schneider
- grid.6936.a0000000123222966Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich (TUM), Orleansstraße 47, 81667 Munich, Germany
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Al Raimi AM, Chong MC, Tang LY, Chua YP, Al Ajeel LY. The effect of mobile applications in enhancing asthma knowledge among school children with asthma in Malaysia. J Pediatr Nurs 2022; 65:e63-e71. [PMID: 35279333 DOI: 10.1016/j.pedn.2022.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE This study set out to evaluate the impact of health education provided on mobile applications (app) to urban-living school children with asthma in Malaysia to improve their asthma-related knowledge. DESIGN AND METHODS This was a quasi-experimental study with pre-and post-intervention involving 214 respondents from six schools were selected randomly and assigned to the experimental and control groups. The intervention, i.e. the health education via mobile apps was given to the experimental group while the control group received the routine face-to-face education. RESULTS The mean knowledge score increased post-intervention in the experimental group from 15.5 ± 8.77 to 24.6 ± 6.69. Children with a moderate level of knowledge accounted for the biggest proportion in both group control and experimental groups in the pre-intervention stage. In contrast, the proportion of children with a high level of knowledge was the highest in the experimental group post-intervention. Therefore, health education delivered via mobile apps led to a statistically significant improvement in the asthma knowledge of the children (F [1, 288] = 22.940, p ≤0.01). CONCLUSION Compared to the conventional face-to-face education methods of lectures or handbooks, mobile technology is more effective in delivering health education and improving the knowledge of school children with asthma. Therefore, educational modules aimed at improving knowledge should be modified to incorporate mobile apps. PRACTICE IMPLICATIONS Health education via mobile applications is considered a great innovation in school children with asthma education, or as a supplement to conventional learning methods. It is necessary to place health education via mobile applications as a prominent learning strategy for school children with asthma.
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Affiliation(s)
- Abdulaziz Mansoor Al Raimi
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia; Seiyun Community College, Hadhramout, Yemen.
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia.
| | - Li Yoong Tang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia.
| | - Yan Piaw Chua
- Department of Mathematics and Science Education, Faculty of Education, Universiti Malaya, Malaysia.
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Doshi H, Hsia B, Shahani J, Mowrey W, Jariwala SP. Impact of Technology-Based Interventions on Patient-Reported Outcomes in Asthma: A Systematic Review. J Allergy Clin Immunol Pract 2021; 9:2336-2341. [PMID: 33548519 DOI: 10.1016/j.jaip.2021.01.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Technology-based interventions (TBIs) can improve asthma management by facilitating patient education, symptom monitoring, environmental trigger control, comorbid condition management, and medication adherence. Collecting patient-reported outcomes (PROs) can identify effective interventions and ensure patient-centered care, but it is unclear which TBIs have been formally evaluated using PROs. OBJECTIVES We aim to: (1) identify the TBIs that have been evaluated in clinical trials using PROs; (2) identify the most commonly used PROs in these trials; and (3) determine the impact of TBIs on PROs in the management of chronic asthma. METHODS We searched the PubMed and Clinicaltrials.gov databases for studies published in English between January 2000 and February 2020 using the following search criteria: "asthma," "IT-based interventions," "information technology," "technology," "dyspnea," "patient reported outcomes," "PROs," "telehealth," "telemedicine," and "mobile devices." Two independent reviewers screened the studies and determined study inclusion. Studies were examined for the types of interventions used, the types of PROs collected, and outcomes. RESULTS The final analysis included 14 clinical trials with either 1, 2, or 3 arms. Five different types of TBIs were identified, most commonly involving multimedia education. Four different categories of PROs were identified, most commonly involving treatment self-efficacy. Positive outcomes in at least 1 PRO domain were reported in 12 of 14 studies. Pooled meta-analysis was not possible due to the heterogeneity of PRO instruments across studies. CONCLUSION TBIs improve PROs overall in patients with asthma. Future trials investigating TBIs should include standardized PROs as endpoints to better clarify this relationship.
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Affiliation(s)
- Hiten Doshi
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | - Brian Hsia
- Mount Sinai School of Medicine, Mount Sinai Hospital, New York, NY
| | | | - Wenzhu Mowrey
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Sunit P Jariwala
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.
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Freitas Ferreira E, Pascoal A, Silva P, Lourenço O, Valente S, Valente MJ, Loureiro M, Gama JMR, Fonseca JA, Taborda-Barata L. Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patients. J Asthma 2019; 57:556-566. [PMID: 30810421 DOI: 10.1080/02770903.2019.1582063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Incorrect inhaler usage is frequent, particularly in elderly asthmatic patients. This study aimed at comparing inhaler technique errors and their determinants, as well inhaler technique self-perception versus real performance, between elderly and non-elderly asthmatics. Methods: Cross-sectional assessment of 92 elderly and 100 non-elderly asthmatics followed at specialty clinics. A standardized questionnaire was applied and inhaler technique demonstration was requested. Errors were assessed using checklists based on manufacturers' instructions and inhaler technique was graded as correct, acceptable or incorrect. Chi-Square Test and Fischer's Exact Test were used for comparative analysis of nominal variables. A p value equal to or less than 0.05 was considered statistically significant. Results: Inhaler technique was correct in a minority of elderly and young patients, without significant differences between study groups. Only 11.1% of the elderly who classified their inhaler as easy and 12.7% who stated their technique was correct had no errors. Previous regular inhaler training was associated with better actual performance in young but not in elderly patients. Conclusion: Our study showed that in spite of regular follow up at specialized outpatient clinics, inhaler devices are associated with a high frequency of errors in elderly and non-elderly asthmatics. In addition, most patients tend to overestimate their technique as correct. Finally, previous, frequent training was associated with a significantly higher percentage of patients showing correct or acceptable technique but only in non-elderly asthmatics, which suggests that elderly asthmatics may need specifically tailored inhaler education programs.
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Affiliation(s)
- Eduardo Freitas Ferreira
- NuESA - Health Environment Study Group, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Adriana Pascoal
- NuESA - Health Environment Study Group, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,Centro de Medicina de Reabilitação da Região Centro Rovisco Pais, Tocha, Portugal
| | - Patrícia Silva
- NuESA - Health Environment Study Group, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Olga Lourenço
- NuESA - Health Environment Study Group, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,CICS - UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Salete Valente
- CHUCB - Department of Pulmonology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Maria Jesus Valente
- CHUCB - Department of Pulmonology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | | | - Jorge M R Gama
- Center of Mathematics and Applications, Faculty of Sciences, University of Beira Interior, Covilhã, Portugal
| | - João A Fonseca
- Centre for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto, Porto, Portugal.,Allergy Unit, CUF Porto Institute and Hospital, Porto, Portugal
| | - Luís Taborda-Barata
- NuESA - Health Environment Study Group, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,CICS - UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,CHUCB - Department of Allergy & Clinical Immunology, Cova da Beira University Hospital Centre, Covilhã, Portugal
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Basheti IA, Obeidat NM, Reddel HK. Inhaler technique education and asthma control among patients hospitalized for asthma in Jordan. Saudi Pharm J 2018; 26:1127-36. [PMID: 30532633 DOI: 10.1016/j.jsps.2018.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 06/26/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives To investigate the effect of inhaler technique education delivered by a clinical pharmacist to patients hospitalised for asthma, on inhaler technique scores and asthma control at three months post-discharge. Methods This pre-post interventional study in Jordan enrolled patients who had been admitted for asthma and were using controller medication by Accuhaler [Diskus] (ACC), Turbuhaler (TH) or Pressurized metered dose inhalers (pMDI). Inhaler technique was assessed using published checklists (score 0–9). Asthma symptom control was assessed by Asthma Control Test (ACT, range 5–25). Patients were assessed on admission (baseline), pre-discharge, and 3 months later. All patients received a ‘Show-and-Tell’ inhaler technique counseling service prior to discharge. Results Baseline data were available for 140 patients, 71% females, mean age 52.7 (SD 16.64) years, mean ACT score 10.0 (SD 4.8). Mean inhaler score was 7.5 (SD 1.52) with no significant difference between the inhaler groups (p = 0.174). After pre-discharge training, all patients had correct technique (score 9/9). After 3 months, mean inhaler scores were significantly higher than at baseline (8.14 (SD 0.87, p < 0.001), with mean change significantly higher for TH 1.21 (SD 2.25) and ACC 0.85 (SD 0.97) than pMDI (0.16; SD 0.72), p = 0.001. Symptom control improved significantly for all patients, with a mean increase in ACT score of 7.54 (SD 8.18), with no significant difference between the inhaler device groups (p = 0.326). Conclusions Patients hospitalized for asthma achieved correct inhaler technique after training by a pharmacist, and maintained better technique at 3 months than on admission. Significant improvements in ACT scores were documented for all inhaler groups.
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Franken MMA, Veenstra-van Schie MTM, Ahmad YI, Koopman HM, Versteegh FGA. The presentation of a short adapted questionnaire to measure asthma knowledge of parents. BMC Pediatr 2018; 18:14. [PMID: 29373963 DOI: 10.1186/s12887-018-0991-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 01/17/2018] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study is to establish asthma knowledge of parents of children (0–18 years) with asthma at the outpatient clinic. Methods A translated and adapted a 21 item Likert type 5 point scale questionnaire (Cronbach’s α-coefficient 0.73) was completed by 291 parents of children with asthma. Total asthma knowledge scores were associated with demographic and psychosocial variables. Results Factor analysis resulted in a new reduced 10 item questionnaire (Cronbach’s α-coefficient 0.72). Higher educational level of parents was associated with better asthma knowledge (p < 0.008 and p < 0.003). Parents showed more knowledge (p < 0.001) on non-medication questions. Asthma knowledge of the parent did not correlate with child age, gender, duration of airway problems, time since diagnosis or severity of asthma. Conclusions Education of parents concerning the working mechanism, indications and use of asthma medications are an essential part of asthma education. Asthma education should be repeated frequently to parents of children with long-term airway problems or diagnosed asthma. Special attention must be paid to parents with only high school education or less.
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Praena-Crespo M, Aquino-Llinares N, Fernández-Truan JC, Castro-Gómez L, Segovia-Ferrera C; GESA network. Asthma education taught by physical education teachers at grade schools: A randomised cluster trial. Allergol Immunopathol (Madr) 2017; 45:375-86. [PMID: 28318759 DOI: 10.1016/j.aller.2016.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/31/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Assess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics' quality of life, asthma knowledge, and reduces school absenteeism. DESIGN Randomised cluster trial parallel group. PARTICIPANTS 2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school. INTERVENTION Implementation of the educational programme "Asthma, Sport and Health" at grade schools, taught by physical education teachers. MAIN OUTCOME Quality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). SECONDARY OUTCOMES Asthma knowledge, asthma control, school absenteeism. RESULTS After implementing the programme in the IS group, global quality of life improved significantly (p<0.001) as did their domains, symptoms (p<0.001), emotional function (p<0.001) and activity limitations (p<0.01), while in the CS group improvement was seen in global life quality (p<0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04-16.98) to 18.16 (CI 95% 17.69-18.62) (p<0.001) and students without asthma from 15.49 (CI95% 15.36-15.63) to 17.50 (CI95% 17.36-17.64) (p<0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism. CONCLUSIONS The ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749.
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Luckie K, Pang TC, Kritikos V, Saini B, Moles RJ. Development and validation of an asthma first aid knowledge questionnaire. Res Social Adm Pharm 2018; 14:459-63. [PMID: 28602277 DOI: 10.1016/j.sapharm.2017.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/20/2017] [Accepted: 05/24/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is no gold standard outcome assessment for asthma first-aid knowledge. We therefore aimed to develop and validate an asthma first-aid knowledge questionnaire (AFAKQ) to be used before and after educational interventions. METHODS The AFAKQ was developed based on a content analysis of existing asthma knowledge questionnaires and current asthma management guidelines. Content and face validity was performed by a review panel consisting of expert respiratory physicians, researchers and parents of school aged children. A 21 item questionnaire was then pilot tested among a sample of caregivers, health professionals and pharmacy students. Exploratory Factor analysis was performed to determine internal consistency. RESULTS The initial 46 item version of the AFAKQ, was reduced to 21 items after revision by the expert panel. This was then pilot tested amongst 161 participants and further reduced to 14 items. The exploratory factor analysis revealed a parsimonious one factor solution with a Cronbach's Alpha of 0.77 with the 14 item AFAKQ. CONCLUSION The AFAKQ is a valid tool ready for application in evaluating the impact of educational interventions on asthma first-aid knowledge.
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Lombardi C, Passalacqua G, Canonica GW. The WEB-based Asthma Control: an intriguing connection or a dangerous hazard? Asthma Res Pract 2015; 1:15. [PMID: 27965768 PMCID: PMC5142388 DOI: 10.1186/s40733-015-0017-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/17/2015] [Indexed: 11/29/2022] Open
Abstract
Globally, an estimated 300 million people have asthma, presenting a considerable and increasing burden of disease for healthcare systems, families, and patients themselves. Despite two decades of guidelines, asthma seems to remain not optimally controlled in a substantial proportion of people. The achievement of asthma control is the result of the interaction among different variables concerning the disease pattern and patients’ and physicians’ knowledge and behavior. It is well known that adherence to treatment increases in parallel to patient education. There is now a growing interest in the use of digital information technologies to promote asthma control and improve outcomes. Mobile health, or mHealth, refers to mobile devices, medical sensors, and communication technologies that can enhance chronic disease care and monitoring. Aim of this review was to evaluate the web resources nowadays available and to analyze the published studies about the web-based instruments used to improve asthma knowledge, control asthma outcomes. In general, studies revealed that the technology is well accepted. Interactive asthma technology may be, in addition, of help in reaching populations difficult to reach, such as inner city populations. The number of tools and apps available continues to increase, and agencies such as the FDA, become involved in their regulation, thus the mHealth landscape will continue to evolve. Although asthma tools and apps have great potential to improve care for asthma, the proof of data reproducibility, the demonstration of effectiveness, and the privacy issues still represent the major technical problems.
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Affiliation(s)
- Carlo Lombardi
- Allergy & Pneumology Departmental Unit Fondazione Poliambulanza Hospital, Via Bissolati, 57, Brescia, Italy
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Obumneme-Anyim I, Oguonu T, Ayuk A, Iloh K, Ndu I. Knowledge of Asthma among Doctors Practicing in Three South Eastern States of Nigeria. Ann Med Health Sci Res 2014; 4:S253-8. [PMID: 25364598 PMCID: PMC4212386 DOI: 10.4103/2141-9248.141968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Asthma is a chronic airway disease that has a significant impact on patients with substantial global socioeconomic burden. Appropriate knowledge by health care practitioners is important in the management of asthma. Aim: The aim was to assess the knowledge of asthma among doctors practicing in health care facilities in three South-Eastern states of Nigeria. Subjects and Methods: This was a descriptive cross-sectional study. The participants were selected using multi-staged sampling method and interviewed with structured, self-administered questionnaires. Comparison of the different outcome variables using the Chi-square (categorical) and Student's t-test (noncategorical) with the characteristics of the participants were done. Result: A total of 283 doctors were interviewed. Eighty-eight percent of them identified asthma as a common disease in our environment, (P = 0.04) but unrelated to socioeconomic status. Knowledge of epidemiology was poor among medical officers and registrars (P = 0.04). Most of the doctors (80%)(226/283) recognized the pathogenic significance of bronchospasm in exacerbation, while 58.6% (166/283) of them considered chronic inflammation as a significant factor in asthma pathogenesis P < 0.001. Majority of the doctors (84.1%) (238/283) were aware of the use of steroids in acute exacerbation, while 59.4% (168/283) considered aminophylline as the first line medication in exacerbation (P = 0.02). Knowledge about the use of steroids as controller medication was noted in 1.7% (5/283) of the respondents. Only 47.3% (134/283) of the participants were aware of the Global Initiative on Asthma guideline, (P = 0.03). Conclusion: There was good knowledge of epidemiology and clinical features of asthma, but a small number of the doctors had knowledge of pathophysiology and treatment of the disease. For best practices in asthma management, there is a need for further education.
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Affiliation(s)
- In Obumneme-Anyim
- Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - T Oguonu
- Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ac Ayuk
- Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Kk Iloh
- Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ik Ndu
- Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria ; Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
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Radic S, Milenkovic B, Gvozdenovic B, Zivkovic Z, Pesic I, Babic D. The correlation between parental education and their knowledge of asthma. Allergol Immunopathol (Madr) 2014; 42:518-26. [PMID: 24948185 DOI: 10.1016/j.aller.2013.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 12/19/2013] [Accepted: 12/23/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of parental education on the success of Asthma Educational Intervention (AEI). METHODS AEI took place after the children's hospitalisation. Parental asthma knowledge was assessed at three time points: before AEI, immediately after, and 12 months later. The Intervention (I) group of parents (N=231) received complete AEI. The Control (C) group of parents (N=71) received instructions for proper use of asthma medications and the handbook. RESULTS Asthma knowledge in I group increased immediately after the AEI (p<0.01), and had not changed (p>0.05) 12 months later. There were four subgroups in group I divided based on education level: elementary school, high school, college, and university degrees. Taking into account the parental education level, there were no differences in the baseline and final knowledge of asthma between subgroups (p>0.05). The number of asthma exacerbations decreased after AEI (5.96:2.50, p<0.01), regardless of the parental degree. Knowledge of asthma in group C did not improve during the study (p=0.17). Final asthma knowledge was higher in group I compared to group C (p<0.01). CONCLUSION The parental education level did not influence the level of asthma knowledge after the AEI. The motivation and the type of asthma education had the greatest input on the final results. PRACTICE IMPLICATIONS All parents should be educated about asthma regardless of their general education.
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Mosnaim G, Li H, Martin M, Richardson D, Belice PJ, Avery E, Ryan N, Bender B, Powell L. The impact of peer support and mp3 messaging on adherence to inhaled corticosteroids in minority adolescents with asthma: a randomized, controlled trial. J Allergy Clin Immunol Pract 2013; 1:485-93. [PMID: 24565620 DOI: 10.1016/j.jaip.2013.06.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 06/13/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents. OBJECTIVE This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS. METHODS Low-income African American and/or Hispanic adolescents, ages 11-16 years old, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm subjects participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages that promoted adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 physician-recorded asthma messages. Adherence was measured by using self-report and the Doser CT, an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the 2 arms. RESULTS Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the 2 arms when adjusting for baseline adherence (P = .929). Adherence declined in both groups over the course of the active treatment period. In both study arms, self-reported adherence by participants was significantly higher than their objectively measured adherence at week 10 (P < .0001). CONCLUSION Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes.
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Affiliation(s)
- Giselle Mosnaim
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill.
| | - Hong Li
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill
| | - Molly Martin
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill
| | - DeJuran Richardson
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill; Department of Mathematics and Computer Studies, Lake Forest College, Lake Forest, Ill
| | - Paula Jo Belice
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill
| | - Elizabeth Avery
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill
| | - Norman Ryan
- Department of Family Practice, Rush Medical College, Chicago, Ill
| | - Bruce Bender
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | - Lynda Powell
- Department of Preventive Medicine, Rush Medical College, Chicago, Ill
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13
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Anwar H, Hassan N, Jaffer N, Al-Sadri E. Asthma Knowledge among Asthmatic School Students. Oman Med J 2008; 23:90-95. [PMID: 22379544 PMCID: PMC3282418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 02/19/2008] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES Bronchial asthma is a common and life threatening problem affecting school children and adolescents. The flare-up of asthma may lead to impaired daily function and absence from school. These complications of bronchial asthma could be influenced by poor knowledge, poor use of inhaler technique, non-compliance and negative attitude toward the illness and drugs. The study is designed to assess the asthma knowledge of school students suffering form asthma and identify the resources of the knowledge. METHODS All diagnosed asthma students (131 cases) selected from school health register grade 7-12 was included in this study. The self administrated questionnaire was distributed among them. It was designed to collect information of the students about epidemiology of asthma, source of their information and effect of the disease on their school attendance. Special knowledge score was constructed to measure the level of the students' knowledge. RESULTS The study showed that from 131 diagnosed asthma cases 90% (118) aware about their diagnosis. Medical and paramedical personnel were found to be the source of knowledge for 49.4% (65) of the students, while teachers were mentioned by only 9.2% (12) of the students as their source of information. Regarding the effect of asthma on school absenteeism, 66% (87) of school students may miss their school due asthma attack. CONCLUSION Health education about bronchial asthma is a need for school students. This require inter-disciplinary approach from various organization particularly the schools. It is vital that school teachers' knowledge be improved and continuously updated that it can reflect in students' knowledge and attitudes too.
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Affiliation(s)
- Huda Anwar
- Directorate of Health Services Wilyate Muttrah, Muscat Region, Ministry of Health, Sultanate of Oman
| | - Nahed Hassan
- Directorate General of Planning, Ministry of Health, Sultanate of Oman
| | - Najla Jaffer
- Wadi Kabir Health Centre, Wilayat Mutrah, Muscat Region, Ministry of Health, Sultanate of Oman
| | - Entsar Al-Sadri
- Department of School Health in Wilayat Mutrah, Muscat Region, Ministry of Health. Sultanate of Oman
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