Investigating the use of Barrows Cards to improve self-management and reduce healthcare costs in adolescents with blood cancer: a pilot study

J Adv Nurs. 2016 Apr;72(4):754-8. doi: 10.1111/jan.12883. Epub 2016 Jan 7.

Abstract

Aim: To test if the Barrows Cards method improves adherence to immunosuppressive therapy self-management following hematopoietic stem-cell transplantation in adolescents affected by blood cancer and reduce costs.

Background: Chronically ill adolescents need to be helped to improve self-management, make sure they can confidently and safely manage therapy at home and reduce readmissions and costs. We identified the Barrows Cards method, originally used to test decision-making skills and critical thinking in medical students. In this pilot study, we tested the efficacy of the Barrows Cards Method in improving adhesion to immunosuppressive therapy in a group of adolescents following hematopoietic stem-cell transplantation and analysed its cost-effectiveness.

Design: A mixed-method study.

Methods: The Barrows Cards method is an educational intervention based on the theory of problem-based learning that uses at least 15 cards specially designed to teach participants how to manage a specific problem. We piloted the Barrows cards method in terms of adherence to immunosuppressive therapy and self-management in a group of 17 adolescents affected by blood cancer before being discharged. Participants were enrolled between 2013-2015. Activity Based Costing was used to analyse the cost-effectiveness.

Results: The Barrows Cards method significantly improved adherence to immunosuppressive therapy in blood cancer adolescents and reduced readmissions. We also showed how this method could significantly reduce healthcare costs.

Conclusions: Further research is required, but the Barrows Cards method could be effectively used by nurses to improve self-management in chronic patients and reduce health costs.

Keywords: barrows cards; chronic illness; costs; nursing; patient education; problem-based learning; safety; self-management.

MeSH terms

  • Adolescent
  • Chronic Disease
  • Cost-Benefit Analysis
  • Decision Making
  • Health Care Costs
  • Hematologic Neoplasms / economics
  • Hematologic Neoplasms / nursing*
  • Humans
  • Immunosuppressive Agents / economics
  • Immunosuppressive Agents / therapeutic use
  • Medication Adherence
  • Patient Education as Topic / economics
  • Patient Education as Topic / methods
  • Pilot Projects
  • Self Care / economics
  • Self Care / standards*

Substances

  • Immunosuppressive Agents