Effect of patient education on self-management skills and health status in patients with asthma: a randomized trial.
We conducted a randomized clinical trial to assess the effectiveness of a newly established education program for adults with asthma. The program was designed to improve patients' health and functional status. Hospitalized patients with asthma were randomly assigned to immediate education or a 6-month waiting list. The education program consisted of three group sessions, delivered by trained educators, and focused on improving patients' self-management skills. Of 253 eligible patients, 131 agreed to participate (66 assigned to immediate education, 65 controls) and 115 (88%) completed the follow-up assessment at 6 months. At follow-up, most indicators of self-management skills and health and functional status had improved significantly among educated patients, but similar improvements were also seen among controls. The trial arms differed significantly on only four variables: patients in the immediate-education group were more likely to develop confidence in their asthma treatment (odds ratio adjusted for baseline [OR] = 2.9; 95% confidence interval [CI]: 1.0 to 8.1), to improve their knowledge of correct inhalation technique (OR = 2.4; 95% CI: 1.0 to 5.7), and to improve knowledge of the peak flow reading that warrants calling a physician (OR = 3.1; 95% CI: 1.4 to 6.7), but they improved less on the Asthma Quality of Life Questionnaire "activity" score (difference: -0.4 on a 1 to 7 scale; 95% CI: -0.8 to 0.0). Use of health services during follow-up was similar in the two groups. The education program did not enhance patients' health and functional status, despite improving a few self-management skills. These results underscore the need for controlled evaluations of education programs.
Perneger
Thomas V
TV
Institute of Social and Preventive Medicine, Geneva University Hospitals, University of Geneva, 24 Micheli-du-Crest, CH-1211 Geneva, Switzerland. thomas.perneger@hcuge.ch
Sudre
Philippe
P
Muntner
Paul
P
Uldry
Christophe
C
Courteheuse
Christiane
C
Naef
Anne-Françoise
AF
Jacquemet
Stéphane
S
Nicod
Laurent
L
Rochat
Thierry
T
Assal
Jean-Philippe
JP
D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000188:drug therapy*; D001294:Attitude to Health; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013726:Terbutaline / Q000008:administration & dosage / Q000627:therapeutic use*
D001993:Bronchodilator Agents; D013726:Terbutaline; D000420:Albuterol