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Feasibility of supported self-management with a pictorial action plan to improve asthma control

Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT....

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Main Authors: Sazlina, Shariff Ghazali, Lee, Ping Yein, Cheong, Ai Theng, Hussein, Norita, Pinnock, Hilary, Salim, Hani, Liew, Su May, Hanafi, Nik Sherina, Abu Bakar, Ahmad Ihsan, Ng, Chiu-Wan, Ramli, Rizawati, Ahad, Azainorsuzila Mohd, Ho, Bee Kiau, Isa, Salbiah Mohamed, Parker, Richard A., Stoddart, Andrew, Pang, Yong Kek, Chinna, Karuthan, Sheikh, Aziz, Khoo, Ee Ming, Collaboration, RESPIRE
Format: Article
Published: Nature Research 2022
Subjects:
RA Public aspects of medicine
RC Internal medicine
Online Access:http://eprints.um.edu.my/41297/
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spelling my.um.eprints.412972023-11-24T01:57:13Z http://eprints.um.edu.my/41297/ Feasibility of supported self-management with a pictorial action plan to improve asthma control Sazlina, Shariff Ghazali Lee, Ping Yein Cheong, Ai Theng Hussein, Norita Pinnock, Hilary Salim, Hani Liew, Su May Hanafi, Nik Sherina Abu Bakar, Ahmad Ihsan Ng, Chiu-Wan Ramli, Rizawati Ahad, Azainorsuzila Mohd Ho, Bee Kiau Isa, Salbiah Mohamed Parker, Richard A. Stoddart, Andrew Pang, Yong Kek Chinna, Karuthan Sheikh, Aziz Khoo, Ee Ming Collaboration, RESPIRE RA Public aspects of medicine RC Internal medicine Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre-post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months followup. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. The proportion of at least one acute exacerbation (3 months: % difference -19.7; 95% CI -34.7 to -3.1; 6 months: % difference -20.3; 95% CI -5.8 to -3.2), one or more emergency visit (1 month: % difference -28.6; 95% CI -41.2 to -15.5; 3 months: % difference -18.0; 95% CI -32.2 to -3.0; 6 months: % difference -20.3; 95% CI -34.9 to -4.6), and one or more asthma admission (1 month: % difference -14.3; 95% 0 -25.2 to -5.3; 6 months: % difference -11.9; 95% CI -23.2 to -1.8) improved over time. Estimated savings for the 59 patients at 6-months follow-up and for each patient over the 6 months were RM 15,866.22 (USD3755.36) and RM268.92 (USD63.65), respectively. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary-care patients. Nature Research 2022-09 Article PeerReviewed Sazlina, Shariff Ghazali and Lee, Ping Yein and Cheong, Ai Theng and Hussein, Norita and Pinnock, Hilary and Salim, Hani and Liew, Su May and Hanafi, Nik Sherina and Abu Bakar, Ahmad Ihsan and Ng, Chiu-Wan and Ramli, Rizawati and Ahad, Azainorsuzila Mohd and Ho, Bee Kiau and Isa, Salbiah Mohamed and Parker, Richard A. and Stoddart, Andrew and Pang, Yong Kek and Chinna, Karuthan and Sheikh, Aziz and Khoo, Ee Ming and Collaboration, RESPIRE (2022) Feasibility of supported self-management with a pictorial action plan to improve asthma control. NPJ Primary Care Respiratory Medicine, 32 (1). ISSN 2055-1010, DOI https://doi.org/10.1038/s41533-022-00294-8 <https://doi.org/10.1038/s41533-022-00294-8>. 10.1038/s41533-022-00294-8
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic RA Public aspects of medicine
RC Internal medicine
spellingShingle RA Public aspects of medicine
RC Internal medicine
Sazlina, Shariff Ghazali
Lee, Ping Yein
Cheong, Ai Theng
Hussein, Norita
Pinnock, Hilary
Salim, Hani
Liew, Su May
Hanafi, Nik Sherina
Abu Bakar, Ahmad Ihsan
Ng, Chiu-Wan
Ramli, Rizawati
Ahad, Azainorsuzila Mohd
Ho, Bee Kiau
Isa, Salbiah Mohamed
Parker, Richard A.
Stoddart, Andrew
Pang, Yong Kek
Chinna, Karuthan
Sheikh, Aziz
Khoo, Ee Ming
Collaboration, RESPIRE
Feasibility of supported self-management with a pictorial action plan to improve asthma control
description Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre-post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months followup. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. The proportion of at least one acute exacerbation (3 months: % difference -19.7; 95% CI -34.7 to -3.1; 6 months: % difference -20.3; 95% CI -5.8 to -3.2), one or more emergency visit (1 month: % difference -28.6; 95% CI -41.2 to -15.5; 3 months: % difference -18.0; 95% CI -32.2 to -3.0; 6 months: % difference -20.3; 95% CI -34.9 to -4.6), and one or more asthma admission (1 month: % difference -14.3; 95% 0 -25.2 to -5.3; 6 months: % difference -11.9; 95% CI -23.2 to -1.8) improved over time. Estimated savings for the 59 patients at 6-months follow-up and for each patient over the 6 months were RM 15,866.22 (USD3755.36) and RM268.92 (USD63.65), respectively. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary-care patients.
format Article
author Sazlina, Shariff Ghazali
Lee, Ping Yein
Cheong, Ai Theng
Hussein, Norita
Pinnock, Hilary
Salim, Hani
Liew, Su May
Hanafi, Nik Sherina
Abu Bakar, Ahmad Ihsan
Ng, Chiu-Wan
Ramli, Rizawati
Ahad, Azainorsuzila Mohd
Ho, Bee Kiau
Isa, Salbiah Mohamed
Parker, Richard A.
Stoddart, Andrew
Pang, Yong Kek
Chinna, Karuthan
Sheikh, Aziz
Khoo, Ee Ming
Collaboration, RESPIRE
author_facet Sazlina, Shariff Ghazali
Lee, Ping Yein
Cheong, Ai Theng
Hussein, Norita
Pinnock, Hilary
Salim, Hani
Liew, Su May
Hanafi, Nik Sherina
Abu Bakar, Ahmad Ihsan
Ng, Chiu-Wan
Ramli, Rizawati
Ahad, Azainorsuzila Mohd
Ho, Bee Kiau
Isa, Salbiah Mohamed
Parker, Richard A.
Stoddart, Andrew
Pang, Yong Kek
Chinna, Karuthan
Sheikh, Aziz
Khoo, Ee Ming
Collaboration, RESPIRE
author_sort Sazlina, Shariff Ghazali
title Feasibility of supported self-management with a pictorial action plan to improve asthma control
title_short Feasibility of supported self-management with a pictorial action plan to improve asthma control
title_full Feasibility of supported self-management with a pictorial action plan to improve asthma control
title_fullStr Feasibility of supported self-management with a pictorial action plan to improve asthma control
title_full_unstemmed Feasibility of supported self-management with a pictorial action plan to improve asthma control
title_sort feasibility of supported self-management with a pictorial action plan to improve asthma control
publisher Nature Research
publishDate 2022
url http://eprints.um.edu.my/41297/
_version_ 1783876715317035008
score 13.211869

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