HEY YA! HE alth Literacy, Y oung Patients with A sthma and A dherence - - PowerPoint PPT Presentation

HEY YA!

HEalth Literacy, Young Patients with Asthma and Adherence to Treatment

EFA Asthma Adolescent Project: Key results and Recommendations

Erna Botjes EFA Vice President London September 20, 2016

Background

• Non-adherence to medical asthma treatment is highly prevalent

among young patients Barrier for positive health outcome and unnecessary high costs,

• So far research on adherence in asthma focused on the views of parents and

physicians EFA decided to ask the adolescents directly to explore underlying mechanisms.

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Research Objectives Patient’s perspective:

the survey provides the missing link to the understanding of poor adherence to asthma therapy: the view of adolescent patients. During fieldwork measures were taken to guarantee that the interview is definitely held with an adolescent patient aged 12-17 years.

Strategy support:

The results can support the development of recommendations to strengthen the adherence of adolescent asthma patients (12-17 years) and contributes to EU Polish and Cyprus Presidencies conclusions and GINA guidelines.

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Development of the questionnaire

• Following a systematic literature review, interviews with asthma

adolescents evoked five themes:

• Daily impact of asthma,
• Health literacy,
• Asthma confrontation,
• Attitude,
• Social Influence.
• The questionnaire was developed on behalf of EFA by Anam

Ahmad, as part of her master thesis at the Maastricht University, NL

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5/24/16 [EY YA EFA] 5 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Category 1 Category 2 Category 3 Category 4

CHART TITLE

Series 1 Series 2 Series 3

Scope

Germany, France, Spain, UK Recruitment and Interview

• Step A (Recruitment only via physicians)
• Step B (Telephone interviews 15-20 min without open ended

questions with asthma patients aged 12-17 years) Target group and sample size N=50 adolescent asthma patients aged 12-17 years per country N=200 interviews over all countries Screening Criteria Asthma patient; 12-17 years; asthma severity known Fieldwork period July - October 2015

Survey Methodology

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CHART TITLE

Series 1 Series 2 Series 3

Demographic characteristics of participants

Every third German respondent achieves the maximal Score

Adherence Score calculated with questions A21a) - A21d)

Adherence Score per country

2 2 2 7 8 7 5 17 3 4 2 4 6 8 11 4 5 3 3 1 5 2 20 2 6 4 7 5 10 15 20 25 10 11 12 13 14 15 16 17 18 19 20 Number of Patients Adherence Score Germany France Spain UK Mean Score 17,9 Mean Score 16,5 Mean Score 15,3 Mean Score 15,8 Median 16 Median 18

Attitude and perceived daily impact of asthma influence the most adherence

Touch Points for Adherence

Touch Points for Adherence

Health Literacy showed a weak, but significant correlation with Attitude (which is the strongest driver of adherence).

Base for Analysis: n=200 (all countries)

Correlation between Health Literacy and the other Touch Points

Health Literacy Asthma Confrontation Attitude Social Support Daily Impact Health Literacy

Total impact on Adherence (ring): 100% R2=0,46 Correlation between Health Literacy and other Touch Points: not significant Weak (r<0,3) but significant

Attitude

Communication based on these six leading items covers together almost 90% of Adherence (Adherence, which is explained by this model).

Driver Analysis: Item Evaluation

24% 22% 14% 11% 10% 7%

Total impact on Adherence: 100% R2=0,57

Base for Analysis: nmin=120, r2=0,57

R1: Sometimes I forget to take my medicine FORGETFULNESS R2: I don't do what my doctor tells me REBELLION R3: When I feel better then I stop taking my Asthma medicine: GOOD DAYS R4: My doctor encourages me to deal with my asthma: DOCTORS SUPPORT R5: I don't take my asthma serious: CARELESS R6: I am aware of the consequences

• f not taking my asthma medicine: IGNORANCE

R7-R13: Sum 13%

Recommendations to support adherence of young asthmatics Scope Six key impactful factors identified 1. Forgetfulness 2. Rebellion 3. Good days 4. Support 5. Carelessness 6. Ignorance Target Adolescents, healthcare professionals, parents

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European Health Policy Recommendations to drive Adherence Purpose

• Recommendations and actions should be integrated into
• EU initiatives and policies on chronic diseases
• EU Member States health coordination and sustainability

plans Target

• EU, national and local policy makers

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European Health Policy Recommendations to drive Adherence

• Promoting multidisciplinary care coordination to better support

adolescent patients and to identify those at risk

• Developing Health Information Technologies (ICTs) specifically

addressed to young patients to stimulate self-management, medication tracking and immediate healthcare feedback

• Empowering young patients through shared decision-making and

tailored health literacy materials to enable adolescents to take responsibility about their own health and asthma medication

• Conducting additional research to picture the long-term consequences

associated with poor adherence in adolescence and to curve down asthma.

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Case study: myAirCoach project

• Funded by Horizon 2020, it aims at developing mHealth solution for the self-

management of asthma

• A smart sensor-based inhaler will monitor and store physiological, behavioural

and environmental factors

• The smart inhaler will be connected to the patients smartphone to provide

patients the possibility to customize their treatment against preset goals and guidelines and in consultation with HCPs

• A virtual community will allow interaction between HCPs, patients, carers,

families

• Thanks to immediate feedback, alarms, educational component, interaction

with others, myAirCoach will be extremely helpful in modifying adolescents’ attitude towards adherence

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European Federation of Allergy and Airways Diseases Patients’ Associations 35 Rue du Congrès 1000 Brussels Belgium Tel.: +32 (0)2 227 2712 Email: info@efanet.org Twitter: @EFA_Patients