Improving Asthma Self Management in Tertiary Students

Abstract

New Zealand is rated seventh highest in the world for the prevalence of asthma, with an estimated 15.1% of the population suffering from this disorder. Poor management of the condition contributes to the severity of the problem despite the availability of adequate treatments. Patient compliance with asthma medication regimes is poor, and the tertiary student population is a particularly noncompliant group with self-reported adherence as low as 44%. The current study had three main aims. The first was to test a method of increasing asthma medication adherence, the second was to improve participants’ technique when using their inhalers, and the third was to make participants aware of the positive outcomes associated with reaching the first two aims and provide them with general education. The intervention used proximal pairing, education, and feedback. Proximal pairing was used as a memory aid, with participants’ inhalers put in a holder along with their toothbrush and toothpaste. Education focused on inhaler technique, and asthma’s triggers and treatment. Feedback on participants’ asthma symptoms, peak flow readings, and technique, was provided at regular intervals. These interventions had a significant positive effect on both adherence and technique, both overall, and for many of the individuals, as well as significantly improving their overall opinion that taking their preventative inhaler reduced asthma symptoms. The results show that days on which preventative inhalers were used at least once increased by 21% after intervention among participants who had poor adherence before intervention. Inhaler technique also improved significantly from 74% accuracy before the intervention to 93% after. Furthermore, the number of people who believed that taking their inhaler was important also increased significantly. These changes were accompanied by an overall significant increase in peak flow, although few individuals achieved a meaningful increase and there was no change in reliever usage. The changes were achieved while maintaining good social validity and at a cost of only about NZ$20 per person per year. These results show promise in not only improving asthma medication management with a simple and affordable intervention, but also for improving adherence of other chronic medicated conditions.