title: Benefit from the inclusion of self-treatment guidelines to a self-management programme for adults with asthma.
abstract: This study assessed the long-term efficacy of adding self-treatment guidelines to a self-management programme for adults with asthma. In this prospective randomized controlled trial, 245 patients with stable, moderate to severe asthma were included. They were randomized into a self-treatment group (group S) and a control group (group C). Both groups received self-management education. Additionally, group S received self-treatment guidelines based on peak expiratory flow (PEF) and symptoms. Outcome parameters included: asthma symptoms, quality of life, pulmonary function, and exacerbation rate. The 2-yr study was completed by 174 patients. Both groups showed an improvement in the quality of life of 7%. PEF variability decreased by 32% and 29%, and the number of outpatient visits by 25% and 18% in groups S and C, respectively. No significant differences in these parameters were found between the two groups. After 1 yr, patients in both groups perceived better control of asthma and had more self-confidence regarding their asthma. The latter improvements were significantly greater in group S as compared to group C. There were no other differences in outcome parameters between the groups. Individual self-treatment guidelines for exacerbations on top of a general self-management programme does not seem to be of additional benefit in terms of improvements in the clinical outcome of asthma. However, patients in the self-treatment group had better scores in subjective outcome measures such as perceived control of asthma and self-confidence than patients in the control group.
authors.affiliation: Dept of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Klein
authors.forename: J
authors.initials: J
authors.lastname: van der Palen
authors.forename: S M
authors.initials: SM
authors.lastname: Uil
authors.forename: G A
authors.initials: GA
authors.lastname: Zielhuis
authors.forename: E R
authors.initials: ER
authors.lastname: Seydel
authors.forename: C L
authors.initials: CL
authors.lastname: van Herwaarden
mesh_terms: D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013997:Time Factors