title: Bronchial asthma and self-management education: implementation of Guidelines by an interdisciplinary programme in health network.
abstract: Asthma is a chronic disease generating very high costs even for Switzerland. Self-management education (SME) is effective and recommended as an integral part of management in the most recent guidelines on asthma treatment. Its aim is to reduce morbidity [hospitalisations (H), lost workdays (LW), emergency consultations (EC)] and improve quality of life (QOL) in these patients.
  
  
  METHODS
  Integrated programme with educational platforms (two-language booklet), SME in 66 patients (30 m, 36 f) with interdisciplinary quality team (pneumologists, primary care physicians, pharmacists, specialised nursing staff), QOL questionnaire. Measurement of morbidity parameters 12 months before and after SME. Measurement of QOL before and 12 months after SME.
  
  
  RESULTS
  Hospitalisations fell from 35 to 8%*, EC from 88 to 53%*. and LW from 39 to 14%* (*p <0.001). Overall, SME resulted in a health cost saving of CHF 202,510 in terms of LW and CHF 131,200 in terms of days in hospital, i.e. a total of CHF 333,710. Costs saved per patient were CHF 5,056 per year. QOL improved with the following scores: overall QOL 4.5 +/- 0.9 to 5.2 +/- 0.9*; activities 4.5 +/- 0.9 to 5.2 +/- 0.9*; symptoms 4.2 +/- 1.1 to 5.2 +/- 1.1*; emotions 4.9 +/- 1.1 to 5.6 +/- 1*; environment 4.5 +/- 1.4 to 4.9 +/- 1.3* (*p <0.001).
  
  
  CONCLUSIONS
  SME by interdisciplinary health network is effective. It brings a steep fall in costs for asthma treatment by cutting back hospitalisations and lost workdays and by improving the asthmatics' quality of life. It should be recognised and better supported by the health system.
authors.affiliation: Centre Valaisan de Pneumologie (CVP), Montana, Switzerland. elisabeth.voland@admin.vs.ch
authors.forename: J M
authors.initials: JM
authors.lastname: Tschopp
authors.forename: J G
authors.initials: JG
authors.lastname: Frey
authors.forename: R
authors.initials: R
authors.lastname: Pernet
authors.forename: C
authors.initials: C
authors.lastname: Burrus
authors.forename: B
authors.initials: B
authors.lastname: Jordan
authors.forename: A
authors.initials: A
authors.lastname: Morin
authors.forename: S
authors.initials: S
authors.lastname: Garrone
authors.forename: K
authors.initials: K
authors.lastname: Imhof
authors.forename: F
authors.initials: F
authors.lastname: Besse
authors.forename: S
authors.initials: S
authors.lastname: Marty
authors.forename: C
authors.initials: C
authors.lastname: Uldry
authors.forename: J P
authors.initials: JP
authors.lastname: Assal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics / Q000628:therapy*; D019058:Community Networks; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012648:Self Care / Q000191:economics