The feasibility and effect of a nurse-led, patient-centered asthma education program in a Nigerian context

Abstract

Rationale, aims and objectives

Insufficient asthma education is an unmet need in Nigeria. We aimed to assess the feasibility of a nurse-led asthma education program and its effect on asthma knowledge and outcomes in Lagos, Nigeria.

Methods

Using a quasi-experimental study design, we recruited participants ≥12 years with physician diagnosed asthma. We assessed asthma knowledge, asthma control, medication adherence, health related quality of life and inhaler technique and also measured lung function. A trained nurse delivered asthma education sessions during the regular clinic visits and demonstrated correct inhaler technique. All assessments were repeated at 3-month. Data was analyzed with descriptive and inferential statistics. A p-value of <0.05 was considered significant for all associations.

Results

Of the 80 participants at baseline, 42 (52.5%) completed the follow-up assessment and were included in the outcome analysis. Their ages ranged from 12 to 75 years, 35 (83.3%) were ≥18 years old and 30 (71.4%) were females. There was significant improvement in knowledge score immediately post intervention (15.48 ± 3.05 versus 18.33 ± 2.21, p < 0.001) and at 3 months (17.52 ± 2.63, p < 0.001). Those with uncontrolled asthma (Asthma Control Test score ≤19) had a meaningful (3.8-point) change in ACT score at follow-up. The improvement in the mean score on the Morisky Medication Adherence Scale was significant (p = 0.03), but a change of 0.48 was not considered meaningful. There was significant (p < 0.001) and meaningful (1.08) improvement in Mini Asthma Quality of Life score at 3 months. Pre-bronchodilator FEV1% predicted and scores on the inhaler technique check list for the Diskus and pressurized meter dose inhaler did not significantly change at follow-up (p = 0.38, 0.26 and 0.80 respectively).

Conclusion

It is practicable for nurses to deliver effective asthma education during regular clinic visits in our practice setting. This training could meaningfully improve asthma control and health related quality of life.

Acknowledgements

GlaxoSmithKline Nigeria facilitated the training of the nurse that delivered the structured education program.

Data availability

The data supporting this document are available on request from the corresponding author.

Conflict of interest

All authors declare no conflict of interest with regards to this study.

Funding

No funding was received for this study.

Author contribution

Conceptualization: OBO, YA, OOA, MGD

Data gathering: OBO, YA, MGD, SKD

Data analysis and drafting of manuscript: OBO, SKD, YA, AT

Revision and final approval of manuscript: All authors.