3.2.1 Involving service users: Considerations, challenges and cautionary tales from a randomised equivalence trial of lay-led asthma self-management education (341)
Jean Hennings, Research Assistant, School of Nursing, Midwifery and Social Work, The University of Manchester, United Kingdom Co authors: Ann-Louise Caress, Martyn Partridge, Clare Brown, Eve Applegate, Malcolm Campbell, Karen Luker & Ashley Woodcock jean.hennings@manchester.ac.uk
Abstract:
Asthma is a significant cause of morbidity worldwide. It represents a considerable burden for both patients (eg reduced quality of life, lifestyle disruption) and healthcare services (eg unscheduled primary care consultations, emergency hospital admissions). There is substantial, high-quality evidence of the efficacy of self-management education in asthma. However, many asthma patients still do not receive such education and fewer than one in four has a written asthma action plan (as recommended in asthma guidelines). Possible contributors to this include lack of healthcare professional time and increasing service pressures in primary care. The potential of service users to contribute alongside health professionals to patient education is increasingly recognised. To date, work has focused primarily on generic education. Exploration of the potential of service users in delivering disease-specific education is needed. However, such work presents important considerations and challenges.
We will draw on experience from a recently completed randomised equivalence trial to highlight and discuss these issues. The trial compared outcomes (healthcare utilisation, asthma outcomes and quality of life) and acceptability (patient satisfaction, perceived enablement and retention) in asthma patients educated by practice nurses and trained lay educators. The study took place in general practices (N=39) in Greater Manchester and London. 567 patients were randomised to care by a practice nurse (N=287) or lay educator (N=280).
This paper focuses on considerations and challenges encountered relating to:
- Identification and recruitment of lay educators
- Training
- Putting lay educators into practice settings (practical issues; research/clinical governance considerations; mentoring; quality assurance)
- Evaluating efficacy/effectiveness
- Sustaining the initiative
We conclude that lay-led asthma self-management education is feasible, but requires considerable resources; attention to practical, logistical and governance issues and on-going support of all parties. The paper seeks to raise awareness, encourage discussion and highlight potential solutions/pitfalls, to inform others undertaking/evaluating comparable work.
Source of Funding: UK - Research Charity/Foundation
Level of funding: 100,001 - 500,000
Biography:
Jean Hennings is a nurse and a midwife. She has worked in a variety of clinical capacities, which include leading a service for pregnant women with diabetes and in hospice care. She has a Masters Degree by Research (equivalent to an MPhil) and has worked since 2005 as a research assistant in the University of Manchester's School of Nursing, Midwifery and Social work, initially on the project which is the subject of this abstract and more recently in the Macmillan Research Unit, located within the School.