An information‐motivation‐behavioural‐based model and adherence to inhalation therapy and other health outcomes in patients with chronic obstructive pulmonary disease: A pilot randomized controlled trial

• Published in: International journal of nursing practice Vol. 26; no. 2; pp. e12799 - n/a
• Main Authors: To, Ka Wing, Lee, Iris Fung‐Kam, Choi, Kai Chow, Cheung, Yannes Tsz Yan, Yu, Doris Sau‐Fung
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01-04-2020
• Subjects: Adherence; Attrition; Chronic obstructive pulmonary disease; Clinical outcomes; Clinical trials; Compliance; Feasibility; Health behavior; Health promotion; Health status; information‐motivation‐behavioural model; inhalation techniques; Intervention; Life control; Motivation; Nursing; Patient compliance; Patient satisfaction; Polls & surveys; Quality of life; nursing; information-motivation-behavioural model; inhalation techniques; quality of life; chronic obstructive pulmonary disease
• ISSN: 1322-7114; 1440-172X
• DOI: 10.1111/ijn.12799

Aims
To explore the feasibility and effects of the programme based on information‐motivation‐behavioural skills (IMB) model (IMB programme) on adherence to inhalation therapy and other health outcomes in chronic obstructive pulmonary disease (COPD) patients.
Background
Poor adherence to inhalation therapy is common among COPD patients. The IMB model is supported by previous studies as useful in promoting adherence to health behaviours.
Methods
This pilot randomized controlled trial randomized 35 COPD patients to receive either the IMB‐based programme or usual care. The 4‐week IMB programme consisted of a face‐to‐face and two telephone sessions to empower patients with skills and knowledge on using inhalation therapy and support their goal attainment for treatment compliance. Outcome evaluation including adherence to inhalation therapy, inhalation techniques, disease impact, and quality of life was conducted at baseline and at 6 weeks after randomization. Feasibility of the IMB programme was evaluated by a satisfaction survey and implementation experience.
Results
Thirty patients completed the study, with an attrition rate of 14.3%. The intervention group (n = 15) had significant improvements in inhalation adherence, inhalation techniques, and quality of life than the control group over the evaluation period. Patient satisfaction survey results and observations on programme implementation suggested the feasibility of the IMB programme.
Conclusion
A IMB model is a feasible and potentially effective intervention for improving COPD patients' adherence to inhalation therapy.
SUMMARY STATEMENT
What is already known about this topic?
Information‐motivation‐behavioural skills (IMB) models have produced positive effects on adherence behaviour in patients with acquired immune deficiency syndrome, coronary heart disease, and diabetes.
What this paper adds?
No study has evaluated the effects of the IMB model on an intervention for adherence behaviour in patients with chronic obstructive pulmonary disease (COPD).
The pilot randomized controlled trial (RCT) showed that the IMB model used in the intervention was effective in improving COPD patients' adherence to inhalation regimen and techniques.
The pilot study found that the IMB intervention programme was feasible for implementation in outpatient settings and was highly accepted by COPD patients.
The implications of this paper:
This programme may be effective in improving COPD patients' adherence to inhalation regimen and inhalation techniques.
The programme is feasible and acceptable.
There is need to conduct an adequately powered multisite RCT to provide stringent outcome evaluation of the IMB intervention programme.
[Correction added on 28 January 2020: 'The implications of this paper' section has been amended.]