On TRACk: a blended intervention incorporating TRaining, prepAration and Counseling to improve inhaler technique and medication adherence in patients with a chronic lung disease

RESEARCH QUESTION: Can on TRACk, a TRain, prepAre, Communicate strategy, improve inhaler medication adherence and inhaler technique of lung patients?
INTERVENTION: On TRACk combines two innovative and proven successful elements: (1) online training of PTs to improve their inhaler medication counseling (both content, including giving a correct inhalation instruction, and patient-centred communication style), (2) preparing technicians and patients for these counseling moments in which inhaler technique is evaluated and medication use is discussed based on topics chosen by patients.

On TRACk, a blended intervention that prepares both patients and pharmacy technicians for two inhaler medication consultations and trains technicians in their communication will improve inhaler medication adherence and inhaler technique in patients with asthma/COPD and lead to better health outcomes

participants fill out questionnaires are t=0, with follow up every three months for a year. Participants in the intervention group will have planned dispence conversations at t=3 and t=9.

In step 1, PTs will be trained with the On TRACk training. Hereto they will videotape five planned second dispense conversations and upload these through a secure connection via their personal account to the On TRACk web portal following strict protocols. Two conversations will be selected by the trainer to perform self-reflection and provide personal feedback, both online.

In step 2, trained PTs invite eligible patients who collect inhaler medication for the first time to participate in the study. For patients, participation involves preparing themselves for a planned second dispense conversation in the pharmacy using materials provided via the On TRACk web portal. Patients hereto are given access with personal log in data to the web portal. Here they will find information about the medication and their illness, and tips and tools to support their self-management. They will select topics for the conversation using a question prompt list (QPL). A QPL is a structured list with questions designed to aid patients’ question asking behavior. This information will be send via the portal to the PT so that (s)he can prepare the conversation using the topics selected by the patient.

In step 3, the planned second dispense conversation takes place in the pharmacy consultation room in which all topics are discussed, as well as demonstration and refinement of the inhaler technique. A follow-up conversation will be planned at six months to monitor inhaler technique (including suitability of the device) and medication use.