TY - JOUR
T1 - Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients–A Qualitative Study
AU - Schrijver, J.
AU - Effing, T.
AU - Brusse-Keizer, M.
AU - van der Palen, J.
AU - van der Valk, P.
AU - Lenferink, A.
PY - 2023
Y1 - 2023
N2 - Whereas exacerbation action plans to self-manage Chronic Obstructive Pulmonary Disease (COPD) significantly improve health outcomes, patients’ adherence to those action plans is often poor. This study aimed to identify facilitators and barriers of adherence to tailored multi-disease exacerbation action plans. We also explored patients’ perspectives toward disease management roles. Individual semi-structured interviews were conducted with a sample of COPD patients who completed a Dutch-Australian self-management intervention evaluating tailored exacerbation action plans for COPD and relevant comorbidities. Interviews were thematically analyzed using a deductive approach guided by the Capability, Opportunity and Motivation of Behavior (COM-B) model. In 2016, ten patients (5 Australian; 5 Dutch; 6 men; age 59-83 years) were interviewed at the end of their one-year follow-up. Facilitators of adherence included improved patients’ comprehension of disease and treatment, positive feelings about the intervention, improved self-confidence, and professional support. Barriers included difficulties to recognize symptoms, dislike toward daily symptom monitoring, negative feelings about the intervention, negative mood state, and complexity of symptom diaries and action plans. Patients indicated three distinctive perspectives of their own and their healthcare professional’s role in their disease management: 1) patients felt mainly responsible; 2) patients felt shared responsibility with their healthcare professional; and 3) patients felt not responsible as they perceived their healthcare professional to be mainly responsible. We successfully used the COM-B model as a guide to identify facilitators and barriers of patients’ adherence to multi-disease exacerbation action plans. Improving patients’ adherence in future self-management interventions by targeting specific facilitators or barriers should be considered.
AB - Whereas exacerbation action plans to self-manage Chronic Obstructive Pulmonary Disease (COPD) significantly improve health outcomes, patients’ adherence to those action plans is often poor. This study aimed to identify facilitators and barriers of adherence to tailored multi-disease exacerbation action plans. We also explored patients’ perspectives toward disease management roles. Individual semi-structured interviews were conducted with a sample of COPD patients who completed a Dutch-Australian self-management intervention evaluating tailored exacerbation action plans for COPD and relevant comorbidities. Interviews were thematically analyzed using a deductive approach guided by the Capability, Opportunity and Motivation of Behavior (COM-B) model. In 2016, ten patients (5 Australian; 5 Dutch; 6 men; age 59-83 years) were interviewed at the end of their one-year follow-up. Facilitators of adherence included improved patients’ comprehension of disease and treatment, positive feelings about the intervention, improved self-confidence, and professional support. Barriers included difficulties to recognize symptoms, dislike toward daily symptom monitoring, negative feelings about the intervention, negative mood state, and complexity of symptom diaries and action plans. Patients indicated three distinctive perspectives of their own and their healthcare professional’s role in their disease management: 1) patients felt mainly responsible; 2) patients felt shared responsibility with their healthcare professional; and 3) patients felt not responsible as they perceived their healthcare professional to be mainly responsible. We successfully used the COM-B model as a guide to identify facilitators and barriers of patients’ adherence to multi-disease exacerbation action plans. Improving patients’ adherence in future self-management interventions by targeting specific facilitators or barriers should be considered.
KW - adherence
KW - Chronic Obstructive Pulmonary Disease
KW - disease management
KW - exacerbations
KW - qualitative research
KW - self-treatment
UR - http://www.scopus.com/inward/record.url?scp=85165918002&partnerID=8YFLogxK
U2 - 10.1080/15412555.2023.2240408
DO - 10.1080/15412555.2023.2240408
M3 - Article
C2 - 37503723
AN - SCOPUS:85165918002
SN - 1541-2555
VL - 20
SP - 262
EP - 273
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
IS - 1
ER -