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Title: Experiences of adherence assessment in asthma
Author: Stewart, Amy
ISNI:       0000 0004 5364 3835
Awarding Body: University of East London
Current Institution: University of East London
Date of Award: 2015
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Background and Aims: Poor adherence to inhaled corticosteroids is understood to be one of the largest contributors to problematic severe asthma in children (Bracken et al., 2009). Researchers have sought to understand and target nonadherence and assessment of adherence is seen as crucial in this process. Recent research has championed electronic monitoring tools as the “gold standard” for accurately measuring adherence and these devices have been extensively evaluated (Burgess, Sly, Devadason, 2011). Only a small amount of literature has considered how one experiences the process of adherence assessment through electronic tools. One such device, the smart-inhaler has been introduced in the paediatric asthma team at the Royal Brompton Hospital. The proposed study aims to explore young people’s experiences of having their adherence to inhaled corticosteroids assessed through a smart-inhaler. It will also explore the experiences of their caregivers and healthcare professionals. Method: Semi-structured interviews were conducted with eight young people with asthma, aged 11-15, who had been given a smart-inhaler as part of their care at the Royal Brompton Hospital, and eight of their caregivers. A focus group with seven healthcare professionals who used the smart-inhalers in their practice was also carried out. Interviews were analysed using a critical realist thematic analysis. Results: Three themes were identified: “they were trying to help me get better”, “it’s clearly just to check up” and “who is responsible?”. They highlight the variety of perspectives and experiences participants had regarding the smartinhaler. More specifically the themes highlighted the importance of participants’ priorities in influencing their experiences, the impact of the smart-inhaler on the healthcare relationship and on the transferring of responsibility for asthma to young people. Conclusions: The findings suggest that it is important for healthcare professionals to engage in a shared decision-making process with their patients when introducing healthcare interventions such as the smart-inhaler.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral