HEY YA! HE alth Literacy, Y oung Patients with A sthma and A dherence to Treatment EFA Asthma Adolescent Project: Key results and Recommendations Erna Botjes EFA Vice President London September 20, 2016
HEY YA! Key results and Recommendations 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. 20/09/16 [Hey YA EFA] 2
HEY YA! Key results and Recommendations 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. 20/09/16 [Hey YA EFA] 3
HEY YA! Key results and Recommendations 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 20/09/16 [HEY YA EFA] 4
HEY YA! Key results and Recommendations Survey CHART TITLE Scope Methodology Germany, France, Spain, UK Category 4 Recruitment and Interview - Step A (Recruitment only via physicians) - Step B (Telephone interviews 15-20 min without open ended Category 3 questions with asthma patients aged 12-17 years) Target group and sample size Category 2 N=50 adolescent asthma patients aged 12-17 years per country N=200 interviews over all countries Category 1 Screening Criteria Asthma patient; 12-17 years; asthma severity known 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Fieldwork period July - October 2015 5/24/16 [EY YA EFA] 5 Series 1 Series 2 Series 3
HEY YA! Key results and Recommendations Demographic CHART TITLE characteristics of Category 4 participants Category 3 Category 2 Category 1 0% 20% 40% 60% 80% 100% Series 1 Series 2 Series 3 20/09/16 [HEY YA EFA] 6
Adherence Score per country Every third German respondent achieves the maximal Score Germany 25 France Spain 20 UK 20 17 Mean Score 17,9 15 Number of Patients 11 10 8 8 7 7 7 6 6 Mean Score 16,5 5 5 5 4 4 4 4 5 3 3 3 2 2 2 2 2 2 Mean Score 15,8 1 0 0 0 0 0 0 Mean Score 15,3 Median 16 Median 18 0 10 11 12 13 14 15 16 17 18 19 20 Adherence Score Adherence Score calculated with questions A21a) - A21d)
Touch Points for Adherence Attitude and perceived daily impact of asthma influence the most adherence Touch Points for Adherence
Correlation between Health Literacy and the other Touch Points Health Literacy showed a weak, but significant correlation with Attitude (which is the strongest driver of adherence). Attitude Health Literacy Asthma Confrontation Attitude Health Literacy Social Support Correlation between Health Literacy Daily Impact and other Touch Points: not significant Weak (r<0,3) but significant Total impact on Adherence (ring): 100% R 2 =0,46 Base for Analysis: n=200 (all countries)
Driver Analysis: Item Evaluation Communication based on these six leading items covers together almost 90% of Adherence (Adherence, which is explained by this model). R3: When I feel better then I stop taking my Asthma medicine: GOOD DAYS 14% R2: I don't do what my doctor tells me 22% REBELLION R4: My doctor encourages me to deal with my asthma: DOCTORS SUPPORT 11% Total impact on Adherence: 100% 10% R5: I don't take my asthma serious: R 2 =0,57 CARELESS 24% R1: Sometimes I forget to take my 7% medicine R7-R13: FORGETFULNESS R6: I am aware of the consequences Sum 13% of not taking my asthma medicine: IGNORANCE Base for Analysis: nmin=120, r2=0,57
HEY YA! Key results and Recommendations 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 20/09/16 [HEY YA EFA] 12
HEY YA! Key results and Recommendations 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 20/09/16 [HEY YA EFA] 13
HEY YA! Key results and Recommendations 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. 20/09/16 [HEY YAEFA] 14
HEY YA! Key results and Recommendations 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 20/09/16 [HEY YAEFA] 15
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
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