The integrated care of asthma in Switzerland (INCAS)–study: Patients' perspective of received asthma care and their interest in asthma education

Abstract

Objective: For successful long-term asthma care, self-management education is a cornerstone. Little is known about associations between patients' interest in education, asthma control and care delivery. We compared patients' characteristics, asthma control and patients' perspective about asthma care in subjects with and without interest in asthma education. Moreover, we assessed reasons, why patients denied participating in asthma education. Methods: Baseline data of 223 patients with asthma (age 43 ± 12 years, 38% male, 58% non-smokers, 13% current smokers), who participated in a multicentre longitudinal controlled study, are reported. At baseline, patients completed the Asthma Control Test (ACT), the Patient Assessment Chronic Illness Care questionnaire (PACIC 5A) and stated their interest in an asthma education programme. Results: Overall, 34% of all participants showed uncontrolled asthma. One hundred and twenty-five (56%) patients were interested in education. Compared to patients without interest, they were characterised by male gender (p = 0.013), worse asthma control (p < 0.001), and perception of lower quality of chronic asthma care delivery, in particular lower self-management support (p < 0.001). Main reasons for rejecting asthma education were having sufficient asthma knowledge, having only mild asthma, receiving adequate medical support and lack of time. Conclusions: More than half of the patients were interested in asthma education. Interest was associated with worse asthma control and lower receipt of care according to the Chronic Care Model. Considering these aspects, this approach may help to improve care quality and allow targeting interventions to those patients who are interested in becoming active participants in their care and who might benefit most.

Keywords:

• Asthma control
• chronic care model
• education programme
• self-management
• 5A-approach

Acknowledgements

We express our appreciation to “Lungenliga Schweiz” and “aha! Allergiezentrum Schweiz” for their collaboration and support concerning the execution of asthma education programmes. Finally, we thank Ulla Schüpbach and Sabrina Maier for their assistance during acquisition of data.

Declaration of interest

The authors of the present study declare to have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Funding

We would like to express our gratitude to MSD Merck Sharp & Dohme AG, CSS and SWICA for their financial support and are grateful for their help and effort during the recruitment process.