Tuberc Respir Dis.  2017 Apr;80(2):169-178. 10.4046/trd.2017.80.2.169.

The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
  • 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea. khyou@kuh.ac.kr
  • 3Department of Clinical Pharmacology, Konkuk University Medical Center, Seoul, Korea.
  • 4Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
  • 5Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 7Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
  • 8Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 10Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
  • 11Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
  • 12Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 13Division of Pulmonary Medicine, Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Korea.
  • 14Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 15Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  • 16Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
  • 17Division of Pulmonology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
  • 18Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 19Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea.
  • 20Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • 21Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
  • 22Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 23Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 24Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 25Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
  • 26Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
  • 27Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

Abstract

BACKGROUND
The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control.
METHODS
Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT).
RESULTS
The study enrolled 144 patients (mean age, 56.7±16.7 years). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from 16.6±4.6 to 20.0±3.9 (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%).
CONCLUSION
This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

Keyword

Asthma; Education; Primary Health Care

MeSH Terms

Adult
Asthma*
Education*
Humans
Nebulizers and Vaporizers
Pamphlets
Physicians, Primary Care
Primary Health Care*

Figure

  • Figure 1 Primary care clinics visits and the process of the education program.

  • Figure 2 Changes in the patients' ability to use their inhalers between pre-education and posteducation. “Can do” at each step was defined as a degree of performance that was “good” or “excellent,” while “Can't do” was corresponded to “bad” or “worst.” (A) He(She) can open the lid correctly. (B) He(She) can hold the inhaler(s) properly. (C) He(She) exhales enough prior to inhalation. (D) He(She) understands the manner of inhalation, such as the rate of inhalation and timing. (E) He(She) holds his(her) breath for at least 5 seconds after inhalation. (F) He (She) breathes out after removing the inhaler from his(her) mouth. (G) He(She) rinses his(her) mouth after using the inhaler. The number above the bars indicates the number of patient cases.

  • Figure 3 The effects on the proportion of patients who had a posteducation asthma control test score of 20 or more according to the frequency of receiving previous general asthma education (A) and inhaler education (B) within the past year.

  • Figure 4 The overall change in the asthma control test (ACT) score between the pre-education and posteducation assessments. The ACT is an asthma control test. The number above the bars indicates the number of patients.

  • Figure 5 Degree of satisfaction, need for education and willingness to pay an additional cost for the asthma education. (A) Q1: Did you learn more about your disease through the education provided by your clinics? (B) Q2: Do you think an education program like this one should be offered to other patients with your disease? (C) Q3: Would you be willing to receive an education like this despite having to pay an additional cost? The number above the bars indicates the number of cases.


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