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dc.contributor.authorHoskins, Gayloren_UK
dc.contributor.authorWilliams, Brianen_UK
dc.contributor.authorAbhyankar, Purvaen_UK
dc.contributor.authorDonnan, Peteren_UK
dc.contributor.authorDuncan, Edwarden_UK
dc.contributor.authorPinnock, Hilaryen_UK
dc.contributor.authorvan der Pol, Marjonen_UK
dc.contributor.authorRauchhaus, Petraen_UK
dc.contributor.authorTaylor, Anneen_UK
dc.contributor.authorSheikh, Azizen_UK
dc.description.abstractBackground/aims  Despite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review.  Methods  The 18-month mixed-methods feasibility cluster pilot trial stratified then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL). Practice asthma nurses and adult patients with active asthma were invited to participate. Primary outcome was asthma-specific quality-of-life. Semi-structured interviews with a purposive patient sample (n=14) and 10 participating nurses explored GOAL perception. The constructs of Normalization Process Theory (NPT) were used to analyse and interpret data.  Results  Ten practices participated (5 in each arm) exceeding our target of eight. However, only 48 patients (target 80) were recruited (18 in GOAL practices). At six months post-intervention, the difference in mean asthma-related quality-of-life (mini-AQLQ) between intervention and control was 0.1 [GOAL 6.20: SD 0.76(CI 5.76–6.65) versus UC 6.1: SD 0.81(CI 5.63–6.57)], less than the minimal clinically important difference (MCID) of 0.5. However, change from baseline was stronger in the intervention group: at six months the change in the emotions sub-score was 0.8 for intervention versus 0.2 for control. Costs were higher in the intervention group by £22.17.  Routine review with goal-setting was considered more holistic, enhancing rapport and enabling patients to become active rather than passive participants in healthcare. However, time was a major barrier for nurses who admitted screening-out patient goals they believed were unrelated to asthma.  Conclusions  The difference in AQLQ score from baseline is larger in the intervention arm than the control, indicating the intervention may have impact if appropriately strengthened. The GOAL intervention changed the review dynamic and was well received by patients, but necessitated additional time, which was problematic in the confines of the traditional nurse appointment. Modification to recruitment methods and further development of the intervention are needed before proceeding to a definitive cluster randomised controlled trial.  The trial was registered on the ISRCTN register (ISRCTN 18912042) on 26th June 2012.en_UK
dc.publisherBioMed Centralen_UK
dc.relationHoskins G, Williams B, Abhyankar P, Donnan P, Duncan E, Pinnock H, van der Pol M, Rauchhaus P, Taylor A & Sheikh A (2016) Achieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthma. Trials, 17 (1), Art. No.: 584.
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_UK
dc.subjectComplex interventionsen_UK
dc.subjectGoal settingen_UK
dc.subjectMixed methodsen_UK
dc.subjectPilot cluster RCTen_UK
dc.titleAchieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthmaen_UK
dc.typeJournal Articleen_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderChief Scientist Officeen_UK
dc.contributor.affiliationEdinburgh Napier Universityen_UK
dc.contributor.affiliationHealth Sciences Stirlingen_UK
dc.contributor.affiliationUniversity of Dundeeen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationNHS Taysideen_UK
dc.contributor.affiliationHealth Sciences Stirlingen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.relation.funderprojectCan eliciting and addressing health-related goals improve asthmaen_UK
rioxxterms.typeJournal Article/Reviewen_UK
local.rioxx.authorHoskins, Gaylor|0000-0002-8393-2342en_UK
local.rioxx.authorWilliams, Brian|en_UK
local.rioxx.authorAbhyankar, Purva|0000-0002-0779-6588en_UK
local.rioxx.authorDonnan, Peter|en_UK
local.rioxx.authorDuncan, Edward|0000-0002-3400-905Xen_UK
local.rioxx.authorPinnock, Hilary|en_UK
local.rioxx.authorvan der Pol, Marjon|en_UK
local.rioxx.authorRauchhaus, Petra|en_UK
local.rioxx.authorTaylor, Anne|en_UK
local.rioxx.authorSheikh, Aziz|en_UK
local.rioxx.projectCZH/4/697|Chief Scientist Office|
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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