Abstract
ICS nonadherence contributes to poor asthma control. Perceptions of asthma and ICS are important determinants, particularly doubts about ICS-necessity (N) and concerns (C) about harm. Our intervention, the Balance Model (BM), communicates a common-sense rationale for ICS-N and addresses C using health psychology theory. We examined its effect on ICS-beliefs and adherence in people without asthma (asthma-naïve, a proxy for newly-diagnosed patients) and with asthma.
We randomised 503 adults reporting asthma and 388 asthma-naïve to: Control (NHS-information) vs BM-text vs BM-video. N-C medication beliefs, adherence and intentions were assessed post-intervention and follow-up (2wk).
Asthma-naïve: BM-video participants reported higher N (F(2,252)=7.1, p=.001) and lower C (F(2,252)=9.6, p<.0001) than controls. Both BM-text and video groups reported higher intentions to adhere than controls post-intervention (F(2,252)=23.2, p<.0001), maintained at follow-up.
Asthma: Medication beliefs group differences were non-significant, but N increased in BM-video participants post intervention (t(150)=-2.54, p=0.012) and follow-up. In the BM-text group C decreased (t(151)=2.19, p=0.029) post intervention only. The BM-text group reported higher adherence at follow-up than controls (t(230)=-2.42, p=0.016).
The BM, especially as a video, could help newly-diagnosed people develop a medically accurate, common-sense understanding of asthma and ICS motivating adherence. In the asthma group the BM changed ICS-beliefs and reported adherence but the effects were smaller, equivalent to NHS-information, likely due to fixed beliefs based on experience, requiring more intensive, personalised approaches.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA1644.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018