Targeted self-directed learning can support clinicians to improve patient adherence to inhaled corticosteroid therapy...

Inhaled corticosteroids (ICS) are the foundation of asthma treatment, yet approximately 50% of patients are sub-optimally adherent to them. ICS non-adherence is associated with significant morbidity including uncontrolled symptoms, exacerbations, hospitalisation and, unfortunately, death. The factors influencing a patient's adherence to inhaled treatments vary, and healthcare professionals (HCPs) require multifactorial skills to address them. Effective tools must be available for HCPs to develop these skills.

To assess if a newly developed self-directed online module changed knowledge of and confidence in the management of ICS non-adherence in asthma.

This study employed a mixed-methods, pre-test and post-test quasi-experimental design. Before starting the module, participants rated their confidence to manage medicine non-adherence in asthma on a 5-item Likert scale (from 'not at all confident' to 'very confident') and answered five multiple choice questions that tested knowledge. The questions were answered again after completing the module. The change in individual knowledge score and confidence pre-module and post-module completion was analysed using a paired sample t-test. Volunteers undertook a semi-structured interview following module completion, and data were scrutinised by thematic analysis.

194 participants completed pre-module and post-module assessments. Compared with baseline, a significant increase in knowledge (t=-17.809, df=193, p<0.001) and confidence scores (t=-12.820, df=193, p<0.001) was noted. Nine participants were interviewed, revealing key themes including how the module changed their understanding of the patient perspective, practical advice gained to support the patient and barriers to making changes in practice.

Completion of the self-directed online module improved HCP knowledge of and confidence to manage non-adherence to ICS in asthma. Further research is required to determine if it has a measurable effect on patients' clinical outcomes.