AN EVALUATION OF A SELF-MANAGEMENT PROGRAM FOR ADULTS WITH ASTHMA (INHALED MEDICATION, COMPLIANCE).

Description

The purpose of this study was to evaluate the impact of a self-management program for adults with moderate to severe asthma on compliance with inhaled, prescribed, non-emergency medications, asthma symptoms and airway obstruction. Subjects were from a rural community in Pennsylvania and were recruited through the media and through the offices of primary care physicians and local pharmacies. Sixty-eight subjects were randomized to one of two groups in this controlled pretest posttest experimental study. Self-efficacy theory served as the framework for this study. Self-efficacy has been demonstrated to be an important component in the ability to self-manage chronic disease. Primary measures included the MDI Chronolog to assess compliance with inhaled medications, the Journal of Daily Asthma Concerns to assess frequency of daily symptoms and a peak-flow meter to appraise airway obstruction. Secondary measures included The Asthma Self-Management Assessment Tool (ASMAT) and The Self-Efficacy for Asthma Management Scale (SEAMS). These measures were completed pre- and post-intervention. Data analysis involved the use of descriptive statistics as well as analysis of covariance and the Mann-Whitney U test. Of the 68 subjects randomized, fifty-five subjects were used in the analysis. Thirteen subjects withdrew from the study before baseline assessment. The major hypotheses in this study were that subjects receiving a self-management program would: (1) increase compliance with inhaled medications, (2) decrease the frequency of asthma symptoms, increase the percentage of symptom-free days and (3) decrease airway obstruction. Hypothesis 1 (U = 271, p =.043) was supported; hypotheses 2 and 3 were not supported. Secondary hypotheses addressed were that subjects attending the self-management program would show (1) an increase in asthma self-management; and (2) an increase in asthma self-efficacy. These additional hypotheses were not supported by the results. Thus, an asthma self-management program can produce increases in medication compliance. There was a trend towards an improvement in health status. Changes in airway obstruction were not observed. Further, improvements in self-management and self-efficacy, as addressed in this study were not found.

Subjects