ORIGINAL RESEARCH PAPER
An information-motivation-behavioural-based model and
adherence to inhalation therapy and other health outcomes in
patients with chronic obstructive pulmonary disease: A pilot
randomized controlled trial
Ka Wing To DN, RN, Registered nurse
1
| Iris Fung-Kam Lee Director, PhD, RN
2
|
Kai Chow Choi PhD, Scientific Officer
2
|
Yannes Tsz Yan Cheung PhD, Post-doc Fellow
2
| Doris Sau-Fung Yu PhD, RN, Professor
2
1
Hong Kong Baptist Hospital, Kowloon Tong,
Hong Kong
2
Nethersole Institute of Continuing Holistic
HealthSchool of Nursing, Faculty of Medicine,
The University of Hong Kong, Shatin,
Hong Kong
Correspondence
Doris Sau-fung Yu, Professor, The Nethersole
School of Nursing, Faculty of Medicine, The
Chinese University of Hong Kong, Shatin,
Hong Kong.
Address: Room 821, Esther Lee Building, The
Chinese University of Hong Kong, Shatin, New
Territories, Hong Kong, China.
Email: dyu@cuhk.edu.hk
Abstract
Aims: To explore the feasibility and effects of the programme based on information-
motivation-behavioural skills (IMB) model (IMB programme) on adherence to inhala-
tion therapy and other health outcomes in chronic obstructive pulmonary disease
(COPD) patients.
Background: Poor adherence to inhalation therapy is common among COPD
patients. The IMB model is supported by previous studies as useful in promoting
adherence to health behaviours.
Methods: This pilot randomized controlled trial randomized 35 COPD patients to
receive either the IMB-based programme or usual care. The 4-week IMB programme
consisted of a face-to-face and two telephone sessions to empower patients with
skills and knowledge on using inhalation therapy and support their goal attainment
for treatment compliance. Outcome evaluation including adherence to inhalation
therapy, inhalation techniques, disease impact, and quality of life was conducted at
baseline and at 6 weeks after randomization. Feasibility of the IMB programme was
evaluated by a satisfaction survey and implementation experience.
Results: Thirty patients completed the study, with an attrition rate of 14.3%. The
intervention group (n = 15) had significant improvements in inhalation adherence,
inhalation techniques, and quality of life than the control group over the evaluation
period. Patient satisfaction survey results and observations on programme implemen-
tation suggested the feasibility of the IMB programme.
Conclusion: A IMB model is a feasible and potentially effective intervention for
improving COPD patients' adherence to inhalation therapy.
AUTHORSHIP STATEMENTThe study was approved by the concerned clinical ethics committees of The Chinese University of Hong Kong (Ref. No. 2014.315-T) and the study hospital (Ref. No.
KW/EX-14-113(76-06)) before patient recruitment. All authors of this article have agreed on the final version of this paper and have met all the following criteria: substantial contributions to
conception and design, acquisition of data, or analysis and interpretation of data, drafting the article, or revising it critically for important intellectual content.CONFLICT OF INTERESTSThe
authors declare no conflict of interest.ORCIDKa Wing TO http://orcid.org/0000-0002-6243-7887Iris Fung-Kam LEE https://orcid.org/0000-0003-0433-1707Kai Chow Choi https://orcid.org/
0000-0001-7157-8668Yannes Tsz Yan Cheung https://orcid.org/0000-0002-5288-9417Doris Sau-Fung YU https://orcid.org/0000-0002-9359-1748
Received: 27 January 2019 Revised: 1 September 2019 Accepted: 18 October 2019
DOI: 10.1111/ijn.12799
Int J Nurs Pract. 2020;e12799. wileyonlinelibrary.com/journal/ijn © 2020 John Wiley & Sons Australia, Ltd 1 of 15
https://doi.org/10.1111/ijn.12799