title: Long-term reduction in asthma morbidity following an asthma self-management programme.
abstract: The adult "credit card" asthma self-management plan has been shown to be an effective and acceptable system for reducing asthma morbidity when introduced as part of a 6 month community-based asthma programme. The aim of the present study was to assess the effectiveness of the credit card plan 2 yrs after the end of the programme. Markers of asthma morbidity and use of medical services were compared during the 12 months before enrolment, and 2 yrs after completing the 6 month asthma programme. Of the 69 participants who originally enroled in the 6 month asthma programme, 58 were surveyed 2 yrs after completion of the programme. These participants showed a significant improvement in all but one of the asthma morbidity measures. The proportion waking most nights with asthma in the previous 12 months decreased from 29 to 9% (p=0.02), emergency visits to a general practitioner decreased from 43 to 16% (p=0.001), hospital emergency department visits with asthma decreased from 19 to 5% (p=0.02) and hospital admissions decreased from 17 to 5% (p=0.04). Only 24% of patients reported that they usually monitored their peak flow rate daily, but this increased to 73% during a "bad" attack of asthma. A long-term reduction in asthma morbidity and requirement for acute medical services can result following the introduction of the adult credit card asthma self-management plan. Adult patients with asthma are most likely to undertake peak flow monitoring preferentially during periods of unstable asthma, rather than routinely during periods of good control.
authors.affiliation: Wellington Asthma Research Group, Dept of Medicine, Wellington School of Medicine, New Zealand.
authors.forename: W J
authors.initials: WJ
authors.lastname: D'Souza
authors.forename: H
authors.initials: H
authors.lastname: Te Karu
authors.forename: C
authors.initials: C
authors.lastname: Fox
authors.forename: M
authors.initials: M
authors.lastname: Harper
authors.forename: T
authors.initials: T
authors.lastname: Gemmell
authors.forename: M
authors.initials: M
authors.lastname: Ngatuere
authors.forename: K
authors.initials: K
authors.lastname: Wickens
authors.forename: J
authors.initials: J
authors.lastname: Crane
authors.forename: N
authors.initials: N
authors.lastname: Pearce
authors.forename: R
authors.initials: R
authors.lastname: Beasley
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000517:prevention & control*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009017:Morbidity; D009819:Office Visits / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010366:Peak Expiratory Flow Rate; D012648:Self Care / Q000379:methods*; D013997:Time Factors