Philip Wireklint1, Mikael Hasselgren1, Scott Montgomery2,3,4, Karin Lisspers5, Björn Ställberg5, Christer Janson6, Josefin Sundh7. 1. School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 2. Clinical Epidemiology and Biostatistics, Örebro University, Örebro, Sweden. 3. Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 4. Department of Epidemiology and Public Health, University College, London, UK. 5. Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden. 6. Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden. 7. Department of Respiratory Medicine, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Abstract
OBJECTIVE: Self-management is important for asthma control. We examined associations of patient- and healthcare-related factors with self-reported knowledge of self-management of worsening asthma. METHODS: Two asthma patient cohorts from 2012 (n = 527) and 2015 (n = 915) were randomly selected from 54 primary health care centers (PHCC) in central Sweden. Data were collected using patient questionnaires and questionnaires to the PHCCs. Logistic regression analyzed associations of relevant variables with knowledge of self-management of worsening asthma. RESULTS: In total, 63% of patients reported moderate to complete knowledge of self-management procedures. The adjusted OR for moderate to complete knowledge relative to high education level was 1.38 [95% CI 1.03-1.85)]; for physician continuity 2.19 (95% CI 1.62-2.96); for a written action plan 11.9 (95% CI 6.16-22.9); for Step 2 maintenance treatment 1.53 (95% CI 0.04-2.24); and 2.07 (95% CI 1.44-2.99) for Step 3. An asthma/COPD nurse visit within the previous 12 months was associated with greater knowledge in women but not in men (p for interaction = 0.042). Smoking [OR 0.56 (95% CI 0.34-0.95)], co-morbidities ≥1 [OR 0.68 (95% CI 0.49-0.93)], and self-rated moderate/severe disease [OR 0.68 (95% CI 0.51-0.90)] were associated with low self-management knowledge. CONCLUSION: Self-reported knowledge of self-management procedures was associated with a higher educational level, physician continuity, a written action plan, advanced treatment and, in women, visiting an asthma/COPD nurse. The results reinforce the importance of implementing guidelines of patient access to a specific physician, a written action plan, and structured education by an asthma/COPD nurse.
OBJECTIVE: Self-management is important for asthma control. We examined associations of patient- and healthcare-related factors with self-reported knowledge of self-management of worsening asthma. METHODS: Two asthmapatient cohorts from 2012 (n = 527) and 2015 (n = 915) were randomly selected from 54 primary health care centers (PHCC) in central Sweden. Data were collected using patient questionnaires and questionnaires to the PHCCs. Logistic regression analyzed associations of relevant variables with knowledge of self-management of worsening asthma. RESULTS: In total, 63% of patients reported moderate to complete knowledge of self-management procedures. The adjusted OR for moderate to complete knowledge relative to high education level was 1.38 [95% CI 1.03-1.85)]; for physician continuity 2.19 (95% CI 1.62-2.96); for a written action plan 11.9 (95% CI 6.16-22.9); for Step 2 maintenance treatment 1.53 (95% CI 0.04-2.24); and 2.07 (95% CI 1.44-2.99) for Step 3. An asthma/COPD nurse visit within the previous 12 months was associated with greater knowledge in women but not in men (p for interaction = 0.042). Smoking [OR 0.56 (95% CI 0.34-0.95)], co-morbidities ≥1 [OR 0.68 (95% CI 0.49-0.93)], and self-rated moderate/severe disease [OR 0.68 (95% CI 0.51-0.90)] were associated with low self-management knowledge. CONCLUSION: Self-reported knowledge of self-management procedures was associated with a higher educational level, physician continuity, a written action plan, advanced treatment and, in women, visiting an asthma/COPD nurse. The results reinforce the importance of implementing guidelines of patient access to a specific physician, a written action plan, and structured education by an asthma/COPD nurse.
Entities:
Keywords:
Self-management; asthma; asthma/COPD nurse; education level; patient-specific physician; primary care; written action plan
Authors: Per Lytsy; Sven Engström; Mirjam Ekstedt; Ingemar Engström; Lars Hansson; Lilas Ali; Maja Kärrman Fredriksson; Jan Liliemark; Jenny Berg Journal: EClinicalMedicine Date: 2022-06-03