The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics

Abstract

Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control.

Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT).

Results: The study enrolled 144 patients (mean age, 56.7±16.7 years). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from 16.6±4.6 to 20.0±3.9 (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%).

Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

Keywords: Asthma; Education; Primary Health Care.

Figure 1. Primary care clinics visits and the process of the education program.

Figure 2. Changes in the patients' ability to use their inhalers between pre-education and posteducation. “Can do” at each step was defined as a degree of performance that was “good” or “excellent,” while “Can't do” was corresponded to “bad” or “worst.” (A) He(She) can open the lid correctly. (B) He(She) can hold the inhaler(s) properly. (C) He(She) exhales enough prior to inhalation. (D) He(She) understands the manner of inhalation, such as the rate of inhalation and timing. (E) He(She) holds his(her) breath for at least 5 seconds after inhalation. (F) He (She) breathes out after removing the inhaler from his(her) mouth. (G) He(She) rinses his(her) mouth after using the inhaler. The number above the bars indicates the number of patient cases.

Figure 3. The effects on the proportion of patients who had a posteducation asthma control test score of 20 or more according to the frequency of receiving previous general asthma education (A) and inhaler education (B) within the past year.

Figure 4. The overall change in the asthma control test (ACT) score between the pre-education and posteducation assessments. The ACT is an asthma control test. The number above the bars indicates the number of patients.

Figure 5. Degree of satisfaction, need for education and willingness to pay an additional cost for the asthma education. (A) Q1: Did you learn more about your disease through the education provided by your clinics? (B) Q2: Do you think an education program like this one should be offered to other patients with your disease? (C) Q3: Would you be willing to receive an education like this despite having to pay an additional cost? The number above the bars indicates the number of cases.