title: Effect of patient education on self-management skills and health status in patients with asthma: a randomized trial.
abstract: 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.
authors.affiliation: Institute of Social and Preventive Medicine, Geneva University Hospitals, University of Geneva, 24 Micheli-du-Crest, CH-1211 Geneva, Switzerland. thomas.perneger@hcuge.ch
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Perneger
authors.forename: Philippe
authors.initials: P
authors.lastname: Sudre
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Christophe
authors.initials: C
authors.lastname: Uldry
authors.forename: Christiane
authors.initials: C
authors.lastname: Courteheuse
authors.forename: Anne-Françoise
authors.initials: AF
authors.lastname: Naef
authors.forename: Stéphane
authors.initials: S
authors.lastname: Jacquemet
authors.forename: Laurent
authors.initials: L
authors.lastname: Nicod
authors.forename: Thierry
authors.initials: T
authors.lastname: Rochat
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Assal
mesh_terms: 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*
chemical_list: D001993:Bronchodilator Agents; D013726:Terbutaline; D000420:Albuterol