title: How does patient education and self-management among asthmatics and patients with chronic obstructive pulmonary disease affect medication?
abstract: The effect of patient education on steroid inhaler compliance and rescue medication utilization in patients with asthma or chronic obstructive pulmonary disease (COPD) has not been previously investigated in a single study. We randomized 78 asthmatics and 62 patients with COPD after ordinary outpatient management. Intervention consisted of two 2-h group sessions and 1 to 2 individual sessions by a trained nurse and physiotherapist. A self-management plan was developed. We registered for 12 mo medication dispensed from pharmacies according to the Anatomical Therapeutic Chemical (ATC) classification index. Steroid inhaler compliance (SIC) was defined as (dispensed/prescribed) x 100 and being compliant as SIC > 75%. Among asthmatics 32% and 57% were compliant (p = 0.04) with a median (25th/75th percentiles) SIC of 55% (27/96) and 82% (44/127) (p = 0.08) in the control and intervention groups, respectively. Patient education did not seem to change SIC in the COPD group. Uneducated patients with COPD were dispensed double the amount of short-acting inhaled beta(2)-agonists compared with the educated group (p = 0.03). We conclude that patient education can change medication habits by reducing the amount of short-acting inhaled beta(2)-agonists being dispensed among patients with COPD. Educated asthmatics showed improved steroid inhaler compliance compared with the uneducated patients, whereas this seemed unaffected by education in the COPD group.
authors.affiliation: Section of Pulmonary Medicine, Medical Department, Vest-Agder Central Hospital, Kristiansand, Norway.
authors.forename: F
authors.initials: F
authors.lastname: Gallefoss
authors.forename: P S
authors.initials: PS
authors.lastname: Bakke
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D012648:Self Care
chemical_list: D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids