An exploratory study of priority information needs in adult asthma patients

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Abstract

The aim of this study was to gain insight into patients’ perspectives on key information needs regarding their asthma. Focused conversation-style interviews were conducted with a purposive sample of 32 patients (aged 18–84 years; males=17, females=15) from five sites (four primary care, one secondary care) in North West England. Interviews were tape recorded and transcribed verbatim, then subjected to line-by-line content analysis. Nine core information needs were identified: current medications; new therapies; medication side effects; triggers of an asthma attack; lifestyle issues; asthma causation; effects of asthma; long term outcome; and symptom control. Individual differences in information need were apparent, as were differences according to asthma severity. The findings highlight some of the challenges facing health professionals when information-giving. The study’s findings could be used in a clinical context to facilitate discussion or to tailor information, and could also provide a basis for future quantitative studies.

Introduction

Asthma is an increasingly common condition, which is a significant cause of morbidity and mortality in the UK [1], [2]. Asthma patients can play an important role in managing their condition on a day-to-day basis [3] and studies suggest that this is associated with improved outcomes [2], [4], [5], [6]. Possession of adequate and appropriate information has been highlighted as being crucial to effective self-management [7], [8], [9].

Asthma patients have been found to be highly desirous of information [10], [11]. However, there is evidence that people with asthma continue to have unmet information needs [8], [11], [12], highlighting the need for more effective approaches to information-giving in asthma-care.

Tailored information-giving has been found to be highly effective in asthma care [5], [13]. However, appropriate tailoring of information requires patients to identify the areas about which they are most desirous of receiving information. There is evidence that patients experience difficulties in articulating their information needs [14], and such difficulties are likely to be exacerbated in the context of a clinical consultation, which is typically time-limited. There is consequently noted to be an over-reliance on professional determinations of the information needed by asthma patients [11], [14]. This is problematic, given that professionals have been found to be poor at identifying patients’ information needs [14], [15] and there may, therefore, be differences between the information which patients are given and the information that they most want. Improved insight into patients’ perceptions of key informational areas in asthma would consequently be of benefit to clinicians, since it could provide them with a focus—or a starting point—for discussion of individual patients’ information needs.

The aim of the current study was therefore to gain insight into patients’ perspectives on key informational areas in asthma by exploring the information needs of a sample of asthma patients.

Section snippets

Methods

The study employed a qualitative approach, informed by Strauss and Corbin [16], because it enabled in-depth exploration of respondents’ information needs, and furthermore allowed respondents themselves to identify those areas about which they were most desirous of receiving information. Approval to conduct the study was sought from Trust management and from relevant research ethics committees. All respondents were provided with an information sheet regarding the study and were asked to sign a

Results

All respondents identified a number of areas about which they would wish to receive information. Nine core information needs were identified from the data (see Box 1). These covered a range of concerns i.e. medications (three categories); triggers of an asthma attack; lifestyle issues; asthma causation; effects of asthma; long term outcome; and symptom control. Each of the nine information needs is presented in greater detail in the sections which follow; the extracts from the data represent

Conclusion

All of the respondents were able to identify the issues and topics about which they would most wish to receive information. The information needs of this sample related to a number of areas, however, there were clear themes and common concerns. The issues raised by these respondents reflect findings of other similar work. For example, Crone et al. [12] found that the highest proportion of calls to a national asthma helpline related to queries about medication. Similarly, some of the issues

Acknowledgements

This project was funded through the National Health Service Executive as part of the NHS National R and D Programme on Asthma Management and is administered by the National Asthma Campaign. The support of both of these agencies is gratefully acknowledged. We wish also to express our gratitude to the respondents and to the staff at the study sites, without whom this work would not have been possible.

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