Astım Yönetiminde Web Tabanlı Eğitimin Etkinliği

Amaç: Bu sistematik derlemenin amacı astımlı bireylere yönelik yapılan web tabanlı eğitim müdahalelerini değerlendirmeyi amaçlamaktadır. Yöntemler: Çalışma, Cochrane, Pubmed ve Science Direct taranarak yürütülmüştür. İngilizce anahtar kelimeler için “Medical Subject Headings” ve Türkçe anahtar kelimeler için ise “Türkiye Bilim Terimleri” dizinlerine bakılmıştır. Derlemeye dâhil edilme kriterleri; web tabanlı astım eğitim müdahalelerini belirten, 2015-2020 yılları içerisinde yetişkin astımlı hastalara yönelik yapılmış, İngilizce ve Türkçe dilinde yayınlanmış randomize kontrollü tüm çalışmalardır. Konuyla ilgili 3.146 çalışma incelenmiştir. Araştırmaya dahil edilme kriterlerine uygun toplam beş yayın çalışma kapsamına alınmıştır. Bulgular: Dahil edilme kriterlerini karşılayan beş çalışmada en az 51 en fazla 330 katılımcıyı içermektedir ve uygulama süreleri en az 3 hafta ve an fazla 12 aydır. Araştırmaların ikisi Birleşik Krallıkta, diğerleri Avusturalya, Kanada ve Almanya’da yapılmıştır. Çalışmaların dördünde rastgele randomizasyon bir tanesinde ise tabakalı randomizasyon yapılmıştır. Derlemeye dahil edilen çalışmalardan iki tanesinde katılımcıların web sitesine maruz kalmasının etkisinin teorik çerçevesi vardır ve pilot uygulama yapılmıştır. Sonuç: Astım yönetiminde web tabanlı eğitimin uygulanabilir olduğu ancak çevrimiçi topluluğun kendi kendine ilaç tedavisine uyumu iyileştirmediği görülmektedir. Konu ile ilgili çalışmaların az olduğu ve daha fazla randomize kontrollü çalışmalara gereksinim olduğu ortaya çıkmıştır.

Anahtar Kelimeler:

Astım, web tabanlı eğitim, internet tabanlı eğitim

Asthma Management Effectiveness of Web-Based Education

Objective: The purpose of this systematic review is to evaluate web-based education interventions for people with asthma. Methods: The study was conducted by scanning Cochrane, Pubmed and, Science Direct. English for the keywords "Medical Subject Headings" and Turkish for the keywords "Turkey Science Terms" analyzed the directory. Inclusion criteria in the review; These are all randomized controlled studies that indicate web-based asthma education interventions, conducted in 2015 and 2020 for adult asthma patients, and published in English and Turkish. 3.146 studies on the subject were examined. A total of five publications that meet the inclusion criteria have been included in the study. Results: The five studies that met the inclusion criteria included a minimum of 51 and a maximum of 330 participants, with implementation times of a minimum of 3 weeks and a maximum of 12 months. Two of the studies were conducted in the UK, the others in Australia, Canada, and Germany. Four of the studies were randomized, and one was stratified randomization. Two of the studies included in the review had a theoretical framework for the impact of participants' exposure to the website and were piloted. Conclusion: Web-based education in asthma management appears to be feasible, but the online community does not improve adherence to self-medication. It has emerged that studies on the subject are few and more randomized controlled studies are needed.

Keywords:

Asthma, web based training, internet based training,

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1. Türk Toraks Derneği Astım Tanı ve Tedavi Rehberi. Turk Thorac J. 2016;17(1):1-108.

2. Global Initiative for Asthma, (GINA). Global Strategy for Asthma Management and Prevention, 2020, Erişim adresi: https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_ wms.pdf , (Ulaşım tarihi: 8 Ocak 2021)

3. Global Asthma Network. The global asthma report.2018. Ulaşım adresi: https://theunion.org/sites/default/files/2020-8/Global%20Asthma%20Report%202018.pdf, (Ulaşım tarihi: 8 Ocak 2021).

4. Papi A, Brightling C, Pedersen SE, Reddel H.K. Asthma. Lancet. 2018;391:783-800. [Crossref]

5. Chung KF. Asthma Phenotyping: a Necessity for İmproved Therapeutic Precision and New Targeted Therapies. J Int Med. 2016;279(2):192- 204. [Crossref]

6. Jameson JL, Longo DL. Precision Medicine-Personalized, Problematic, and Promising. Obstet Gynecolog Survey. 2015;70(10):612-614. [Crossref]

7. Braido F. Failure in Asthma Control: Reasons and Consequences. Scientifica. 2013;1-15. [Crossref]

8. Bundesärztekammer K, Der Wissenschaftlichen A. Nationale VersorgungsLeitlinie Asthma-Langfassung, 2018; 3rd edition.

9. Pinnock H, Parke HL, Panagioti M, et al. Systematic meta-review of supported self-management for asthma: a healthcare perspective. BMC Medicine. 2017;15(1):1-32. [Crossref]

10. Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: Final Data for 2014. Hyattsville: National Center for Health Statistics, 2016;65(4):1-122.

11. Turnbull S, Cabral C, Hay A, Lucas PJ. Health Equity in the Effectiveness of Web-Based Health Interventions for the Self-Care of People With Chronic Health Conditions: Systematic Review. J Med Inter Res. 2020;22(6):e17849. [Crossref]

12. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for and meta-analysis protocols (PRISMA-P) 2015 statement. System Reviews. 2015;4(1):1-9. [Crossref]

13. Morrison D, Wyke S, Saunderson K, et al. Findings from a pilot Randomised trial of an Asthma Internet Self-management Intervention (RAISIN). BMJ Open. 2016;6(5):e009254. [Crossref]

14. Lau AY, Arguel A, Dennis S, Liaw S, Coiera E. “Why Didn’t it Work?” Lessons From a Randomized Controlled Trial of a Web-based Personally Controlled Health Management System for Adults with Asthma. J Med Int Res. 2015;17(12):e283. [Crossref]

15. Koufopoulos JT, Conner MT, Gardner PH, Kellar I. A Web-Based and Mobile Health Social Support Intervention to Promote Adherence to Inhaled Asthma Medications: Randomized Controlled Trial. J Med Int Res. 2016;18(6):e122. [Crossref]

16. Ahmed S, Ernst P, Bartlett SJ, et al. The Effectiveness of Web-Based Asthma Self-Management System, My Asthma Portal (MAP): A Pilot Randomized Controlled Trial. J Med Int Res. 2016;18(12):e313. [Crossref]

17. Kohler B, Kellerer C, Schultz K, et al. An Internet-Based Asthma Self-Management Program Increases Knowledge About Asthma: Results of a Randomized Controlled Trial. Deutsches Ärzteblatt International. 2020;117(5):64-71. [Crossref]

18. Juniper EF, O’Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and Validation of a Questionnaire to Measure Asthma Control. Eur Respir J. 1999;14(4):902-907. [Crossref]

19. Juniper EF, Guyatt GH, Cox FM, Ferrie PJ, King DR. Development and Validation of the Mini Asthma Quality of Life Questionnaire. Eur Respir J. 1999a;14(1):32-38. [Crossref]

20. Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and Testing of a Short Form of the Patient Activation Measure. Health Servi Res. 2005;40(6p1):1918-1930. [Crossref]

21. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive Validity of a Medication Adherence Measure in an Outpatient Setting. J Clin Hyper. 2008;10(5):348-354. [Crossref]

22. Rabin R, Charro Fd. EQ-SD: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337-343. [Crossref]

23. Venkatesh V, Davis FD. A Theoretical Extension of the Technology Acceptance Model: Four Longitudinal Field Studies. Management Science. 2000;46(2):186-204. [Crossref]

24. Knobel H, Alonso J, Casado JL, et al. Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS. 2002;16(4):605-613. [Crossref]

25. Lorig K, Chastain RL, Ung E, Shoor S, Holman HR. Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheumatism. 1989;32(1):37-44. [Crossref]

26. Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. Canadian Med Assoc J. 2012;184(3):191-196. [Crossref]

27. Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53-72. [Crossref]

28. Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self-report with other measures of medication adherence: a summary of the literature. Medical Care. 2004; 649-52. [Crossref]

29. Shi L, Liu J, Fonseca V, Walker P, Kalsekar A, Pawaskar M. Correlation between adherence rates measured by MEMS and self-reported questionnaires: a meta-analysis. Health and Quality of Life Outcomes. 2010;8(1):99. [Crossref]

30. McDermott MS, While AE. Maximizing the healthcare environment: A systematic review exploring the potential of computer technology to promote self-management of chronic illness in healthcare settings. Patient Education and Counseling. 2013;92(1):13-22. [Crossref]

31. Morrison D, Wyke S, Agur K, et al. Digital Asthma Self-Management Interventions: A Systematic Review. J Med Int Res. 2014;16(2):51. [Crossref]

32. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991;50(2):179-211. [Crossref]

33. Anhøj J, Nielsen L. Quantitative and Qualitative Usage Data of an Internet-Based Asthma Monitoring Tool. J Med Int Res. 2004;6(3):23. [Crossref]

34. Yardley L, Ware LJ, Smith ER, et al. Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care. IJBNPA. 2014;11(1):1-11. [Crossref]