Health beliefs associated with poor disease self-management in smokers with asthma and/or COPD: a pilot study

Abstract

Background: Compared to nonsmokers, smokers with chronic disease are less likely to adhere to self-management recommendations for the management of their chronic conditions. Although the literature notes poor adherence trends in smokers, actual influences of adherence in these patients require further study. This study examines the health beliefs that influence self-management behaviors in smokers with chronic lung disease. Methods: This prospective, cross-sectional study surveyed patients (n = 83) seen in the pulmonary outpatient clinics of the University Medical Center of New Orleans between November 2015 and February 2016. Eligible patients included those between 40–64 years old diagnosed with asthma and/or chronic obstructive pulmonary disease (COPD). Primary measures included perceived beliefs related to the susceptibility to asthma and/or COPD becoming worse, perceived barriers to adherence, and perceived benefits to adherence. Patient characteristics under-study included smoking status, race, gender, and diagnosis. Descriptive and chi-square analyses were performed to characterize the sample. Student’s t and and regression analyses were conducted to examine the relationships between perceptions, smoking status, race, gender, and diagnosis. Results: Compared to nonsmokers, smokers perceived their asthma and/or COPD becoming worse (p = 0.0023). Smokers also perceived more barriers (p < 0.0001), and fewer benefits to adherence than nonsmokers (p = 0.0021). Conclusion: The health beliefs of smokers may influence their self-management behaviors. Results of this study can inform the development of services that target smokers in order to improve adherence to self-management behaviors and health outcomes.

Keywords:

• Smokers
• adherence
• disease management
• Health Belief Model
• patient perceptions

Acknowledgement

We acknowledge the contributions made by the Louisiana Tobacco Control Initiative field staff and the cooperation of the Louisiana State University Health Care Services Division. We also acknowledge the support of the LSU School of Public Health’s Department of Behavioral and Community Health Sciences, University of North Carolina at Chapel Hill’s Eshelman School of Pharamacy’s Division of Pharmaceutical Outcomes and Policy, and Visionary Consulting Partners, LLC. These findings have not been presented or published previously.

Disclosure statement

The authors report no conflicts of interest related to this research and manuscript.

Additional information

Funding

This study was supported by a contract (CFMS no. 599454) from the Louisiana Cancer Research Consortium (http://www.louisianacancercenter.org). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.