Impact of a behavioral-based intervention on inspiratory muscle training prescription by a multidisciplinary team.

Author: Simms AM, Li LC, Geddes EL, Brooks D, Hoens AM, Reid WD.
Affiliation: Department of Physical Therapy, University of British Columbia, Canada.
Conference/Journal: J Contin Educ Health Prof.
Date published: 2012 Spring
Other: Volume ID: 32 , Issue ID: 2 , Pages: 116-25 , Special Notes: doi: 10.1002/chp.21134 , Word Count: 264


INTRODUCTION:
Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR).
METHODS:
Six hospital PR programs were randomly assigned to a behavioral- or information-based intervention. Both interventions provided evidence supporting IMT and its prescription details. However, the behavioral-based intervention focused on barriers and challenges to IMT prescription informed by a nationwide survey and the theory of planned behavior (TPB). It included hands-on practice and content, in part, was driven by learners' questions. In contrast, the information-based intervention delivered information in a typical didactic education session followed by a demonstration and question period. It was supplemented with evidence-based research articles. The primary outcome was the change in prescription rate of IMT for COPD patients by determining the difference during the 6 months preceding compared to the 6 months during the interventions.
RESULTS:
Sixty-one health professionals and 488 COPD outpatients within 6 PR programs participated. No COPD patients were prescribed IMT at any of the sites during the 6-month preintervention phase. The behavioral-based intervention resulted in an IMT prescription rate of 10.2% to people with COPD, whereas the information-based intervention resulted in no IMT prescriptions.
DISCUSSION:
A behavioral-based intervention that is based on TPB and addresses challenges identified by health professionals is more effective than a traditional lecture approach to increase health professionals' prescription of IMT for patients with COPD.
Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.
PMID: 22733639