Newsletters and Adherence to a Weekly Home Spirometry Program after Lung Transplant

Abstract

Context-Newsletters are a common intervention for patients in clinical trials. However, it is not clear whether newsletters are associated with increased adherence to the health regimen, and if so, which aspects of the newsletter are reported as most helpful to patients.Objective-To examine the association between patients' ratings of worthwhileness of a quarterly newsletter and adherence with a home spirometry regimen.Design-Patients (n = 48) were in a research-based spirometry program after lung transplant and had received at least 1 newsletter; 24 (50%) returned completed surveys via postal mail.Main Outcome Measures-Adherence for forced vital pulmonary function tests for respondents versus nonrespondents, number of weeks they were adherent, ratings they gave the newsletter, and which components of the newsletters were helpful to the respondents.Results-Respondents had more forced vital capacity pulmonary function tests ("blows") overall, blew more times weekly, and blew more consistently from week to week than did nonrespondents. Although it was not statistically significant, a mild correlation was found between the number of weeks that the respondents were adherent and their ratings of the newsletter (r = 0.36, P = .08). Most respondents reported that newsletter length was "about right," and 86% reported that newsletters helped encourage regular spirometer use, maintain interest in the study, educate about general health, and alert readers to seasonal health risks.Implications for Practice-High ratings for newsletters used to encourage participation among adults in our home spirometry study were associated with higher adherence.Nonadherence to health care and clinical research regimens is a barrier both to optimal health outcomes for patients and high-quality research. 1 Sending newsletters to patients and research participants as a part of patients' follow-up care is common practice in health care and clinical research. Newsletters are generally convenient, inexpensive, and easy to produce. 2

Immunosuppressive therapy after solid-organ transplantation: does the INTERMED identify patients at risk of poor adherence?

“…Only 1 out of 5 liver SOT recipients were included because after initiating the study, the Geneva University Hospital became the sole centre for liver transplantation in the French speaking part of Switzerland, thus making follow up in Lausanne impossible. Other studies23,46,47 assessing adherence and psychosocial factors in post-transplant patients reported similarly high exclusion rates (between 37.3% and 58.3%). Moreover, the fact that candidates for liver transplantation, who are usually complex due to a high prevalence of substance abuse and its psychosocial consequences, were underrepresented, might have decreased the case complexity of the sample and decreased the statistical power of the INTERMED with regard to medication adherence.…”

L’éducation du patient à domicile : une revue de la littérature

“…Plus de la moitié des articles retenus provient du monde anglo-saxon [8][9][10][11][12][13][14][15][16][17][18][19]. Deux tiers sont issus du domaine universitaire, et seule une publication relève d'un service de soins à domicile [27].…”

“…Un peu plus de la moitié des études fait référence à des actions éducatives menées au domicile du patient, en présentiel, I. Heyden et al lors de la visite d'un professionnel. L'autre moitié correspond à de l'éducation réalisée par le biais de dispositifs à distance (télémédecine, telehealth, webside) ou de matériels papiers mis à disposition du patient [14,17] tels que les guides [23] et les newsletters [10].…”

“…Celui de selfcare est relié aux concepts de maladie, traitement et santé. L'éducation du patient tendrait à permettre au patient de poser des actions concrètes en vue d'agir sur sa santé (utiliser le spiromètre [10], gérer la dialyse [18], contrôler le diabète au niveau métabolique [13]). Parfois, aucune précision n'est apportée en matière de self-care (construire ou améliorer les comportements de self-care, prendre soin de sa santé).…”

“…D'une manière générale et comme l'illustre le tableau III, les objectifs spécifiques cités semblent avant tout relever de l'information et de la connaissance. Ils peuvent notamment porter sur la santé [15][16][17]20], la maladie [8,15,20,25], ses conséquences [25] et sa gestion [8,15,22,23], sur le traitement [22,23] et les bénéfices attendus de celui-ci [25] ou encore sur les dispensateurs de soins [10] et les dispositifs ou mesures de prévention [9][10][11]27]. Un article fait également référence à la mise à disposition de témoignages d'autres patients [10].…”