Factors Influencing Use of Personalized Asthma Action Plans among Adult Patients Aged 18-65 in Nyamira County Kenya

Abstract

Introduction: Globally the World Health Organization (WHO) estimates that up to 334 million people suffer from asthma. In Kenya it is estimated that about 10% of the Kenyan population, or 4 million people, have asthma.
 Aim: The objective of this study was to assess factors influencing the use of personalized asthma action plans among patients aged 18-65 in Nyamira County.
 Methodology: Cross-sectional study design was employed in this research. Participants were selected using systematic sampling. Significant differences in categorical variables were found using the Chi-square and Fisher's Exact Test. The threshold for statistical significance was set at p<0.05.
 Results: The study sample size was 220 asthma patients. Findings showed that majority did not use PAAPs with a response of 168(76.4%) respondents while those who used were 52(23.6%). Knowledge on PAAPs was low at 160(72.7%) against, 60(27.3%) who were knowledgeable. There was poor attitude and practices on use of PAAPs. Statistically there were significant association between the various patients’ factors influencing use of asthma action plans among adult asthmatic patients with a p = 0. 021. Among the health care givers, on knowledge of PAAPs 3 had knowledge while 3 did not. Among those who had knowledge the practice on use was low in which majority indicated that they don’t discuss and prescribe PAAPs with a response of 5 while 1 do. Statistically there were significant association on the health care workers’ factors influencing use of PAAPs at p = 0.03. Lack of training was a key institutional factor hindering use in which 3 (60.0%) had received training in the last 6 months while 2(40.0%) had not received. Statistically there were significant association on the institutional factors influencing use of PAAPs at p = 0.004.
 Conclusion: From the respondent’s majority of the patients were found not to be using the personalized asthma action plan cards. Lack of knowledge was a leading factor among the patient’s respondents. There was also a poor attitude reported in the patients’ respondents in which majority felt that they were for very sick patients. Among the health care givers; only one out of the six had this template/card in their office. Although half of the health care givers had general knowledge but it was not demonstrated in the use of PAAPs hence showing a gap in some specific skills needed. More workload and lack of these templates in the clinics were the major institutional factors hindering use of these tools.