Researchers aim to improve asthma patients' care through computer-based simulation program

Mayo Clinic pulmonary researchers have designed and tested a new patient education computer program intended to help people with asthma manage their disease. The program allows asthma patients (an estimated 7 percent of the U.S. adult population) to practice making key decisions in a safe, simulated environment.

The Mayo Clinic group will present results of a study assessing users’ experiences at the American Thoracic Society’s 2008 International Conference in Toronto.

To improve delivery of asthma patient education messages, the Mayo team created a user-friendly tool called CASPER (Computerized Asthma Self-management Program and Educational Resource for adults). CASPER is an interactive story-based, Web-enabled asthma simulation program to enhance patients’ ability to consistently treat their asthma. To progress through CASPER, patients answer questions displayed on the screen following a simulated asthma-attack scenario, such as “Bob’s Night Time Wakening.” The scenario portrays a familiar asthma event in pictures and text, and asks patients how to treat it. In response to the choice they enter on the computer, patients receive a comment that explains the best action to take in the story scenario, as well as why the other choices are not as effective.

This type of education is needed, researchers say, because learning how to manage asthma can be challenging for patients. They have a range of triggering events to anticipate, varied medications to take, and multiple methods for doing so, such as choosing from among long-term steroids, quick-relief inhalers and over-the-counter medications.

Patient self-management of asthma requires intensive education, says Kaiser Lim, M.D., a specialist in pulmonary and critical care medicine and lead researcher on the project. “Imagine if we are able to empower our patients by simulation and have them learn vicariously,” he says. “We envision that this phase of patient education will come after the initial teaching sessions, and it will allow patients to synthesize all the information we have imparted.”

Overall, the computer-based experience was positive for users, Dr. Lim says, showing promise as a tool that can help manage disease and control medical costs. “It is well documented that there is an increasing need for innovative educational programs for chronic disease self-management,” he says. “But before we can judge the efficacy of this approach, the usability of these programs must be systematically and rigorously evaluated, and that’s what we’ve begun to do with CASPER.”

This story-based Web-based simulation approach to patient education holds high potential for improving management of other diseases as well. It can be used to address other pressing health problems, such as how to manage insulin, perform exercise, make food choices, and monitor hypertension and congestive heart failure, Dr. Lim says.

To assess the effectiveness of this educational approach, the Mayo researchers recruited 20 patients who had been diagnosed with asthma. The study participants used the computer program with minimal instruction while a usability expert evaluated ease of use. More data from the patients’ experience was gathered through surveys after patients used the computer program and from brief interviews about the experience.

Results from observing and interviewing asthma patients using the computer education program show that CASPER’s strengths include its:

-- Story-based format. Patients generally found the narratives engaging, enjoyable and easy to follow.

-- Use of Q&A structure. This organizational technique helped clarify messages.

-- Ease of navigation. Even without instruction from a person on how to use the computer program, patients generally progressed as intended through the sequence of educational messages.

--Completion rate. Most users finished each asthma scenario as intended.

Researchers also found that several design elements of CASPER need further refinements, such as preventing detours from the intended messages through hyperlinks that distract from the delivery of a consolidated message.

The research demonstrated two main points about improving the effectiveness of patient-centered, computer-based education programs for adult asthma patients:

-- Usability guidelines aren’t enough to assure optimal use. Target-audience testing is required, too. Even when the components of design were based on established usability principles, the resulting application still had to be tested by the target audience to fine-tune its operation. Barriers to optimal utilization that emerged in target-audience testing included navigational issues, screen layout, consistency in content and design.

-- A story-based, question-and-answer format is effective and helpful in the patient-centered, computer-based education setting for teaching adults about asthma management. Study participants confirmed the desirability of this approach, reporting that they found the program educational, engaging and entertaining.

Source: Mayo Clinic

Related stories:

Study suggests sick children should be tranferred to specialty hospitals sooner
Critically ill children admitted to the pediatric intensive care units of regional medical centers from smaller hospitals are sicker than those admitted directly from those centers' own emergency rooms, a study by pediatric critical care physicians at UC Davis Children's Hospital has found.
Research findings open new front in fight against AIDS virus
A research group supported by the National Institutes of Health (NIH) has uncovered a new route for attacking the human immunodeficiency virus (HIV) that may offer a way to circumvent problems with drug resistance. In findings published today in the online edition of the Proceedings of the National Academy of Sciences, the researchers report that they have blocked HIV infection in the test tube by inactivating a human protein expressed in key immune cells.
Dust mites outlast heroic efforts to help asthma patients
Asthma sufferers might as well stop wasting energy and money on labor-intensive or costly interventions to get rid of household dust, according to a new review of studies.
First do no harm? UH prof taking opposite approach to treat asthma
One month of tough breathing may help asthma sufferers breathe easier in the long run, according to research from one University of Houston professor.
Researchers investigate link between fungal proteins, innate immunity and asthma
Researchers at Mayo Clinic and the Virginia Bioinformatics Institute (VBI) have received a second grant from the National Institute of Allergy and Infectious Diseases (NIAID) to advance understanding of the role of environmental fungi in chronic airway disorders. Recently NIAID awarded the researchers a further $1.8 million for these studies over a five-year period to investigate how the environmental fungus Alternaria triggers airway inflammation and bronchial asthma.
Antibiotic treatment targets difficult asthma
Hunter researchers have shown that a commonly available antibiotic can improve the quality of life of patients with difficult asthma, and may also generate significant health care savings.
Study: Who claims to be a pediatrician?
Up to 17 percent of physicians who claim to be pediatricians are not board certified by ABP
Ann Arbor, Mich. – How well do you know your child's pediatrician" Is he or she board certified in pediatrics, or has he or she ever completed specialty training in the field"
Survey shows asthma not controlled in majority of patients
WINSTON-SALEM, N.C. – A survey of 1,812 patients with moderate-to-severe asthma revealed that the disease was not controlled in 55 percent, despite the fact that most had health insurance and visited their health care providers regularly.

News discussion:

Medicine & Health news