Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study
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 act...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | COPD |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/15412555.2023.2240408 |
| _version_ | 1797403963683766272 |
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| author | J. Schrijver T. Effing M. Brusse-Keizer J. van der Palen P. van der Valk A. Lenferink |
| author_facet | J. Schrijver T. Effing M. Brusse-Keizer J. van der Palen P. van der Valk A. Lenferink |
| author_sort | J. Schrijver |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T02:47:17Z |
| format | Article |
| id | doaj.art-547f5624ce0c4cb6bc85870c757099c2 |
| institution | Directory Open Access Journal |
| issn | 1541-2555 1541-2563 |
| language | English |
| last_indexed | 2024-03-09T02:47:17Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | COPD |
| spelling | doaj.art-547f5624ce0c4cb6bc85870c757099c22023-12-05T16:09:51ZengTaylor & Francis GroupCOPD1541-25551541-25632023-12-0120126227310.1080/15412555.2023.22404082240408Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative StudyJ. Schrijver0T. Effing1M. Brusse-Keizer2J. van der Palen3P. van der Valk4A. Lenferink5Section Cognition, Data and Education, Faculty of Behavioral, Management and Social Sciences, University of TwenteCollege of Medicine and Public Health, Flinders UniversityHealth Technology and Services Research, Faculty of Behavioral, Management and Social sciences, Technical Medical Centre, University of TwenteSection Cognition, Data and Education, Faculty of Behavioral, Management and Social Sciences, University of TwenteDepartment of Pulmonary Medicine, Medisch Spectrum TwenteDepartment of Pulmonary Medicine, Medisch Spectrum TwenteWhereas 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.http://dx.doi.org/10.1080/15412555.2023.2240408chronic obstructive pulmonary diseaseadherencedisease managementself-treatmentexacerbationsqualitative research |
| spellingShingle | J. Schrijver T. Effing M. Brusse-Keizer J. van der Palen P. van der Valk A. Lenferink Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study COPD chronic obstructive pulmonary disease adherence disease management self-treatment exacerbations qualitative research |
| title | Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study |
| title_full | Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study |
| title_fullStr | Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study |
| title_full_unstemmed | Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study |
| title_short | Facilitators and Barriers of Adherence to Multi-Disease Exacerbation Action Plans in COPD Patients – A Qualitative Study |
| title_sort | facilitators and barriers of adherence to multi disease exacerbation action plans in copd patients a qualitative study |
| topic | chronic obstructive pulmonary disease adherence disease management self-treatment exacerbations qualitative research |
| url | http://dx.doi.org/10.1080/15412555.2023.2240408 |
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