title: Does smoking affect the outcome of patient education and self-management in asthmatics?
abstract: Information on the potential effect of smoking on the outcome of patient education in asthma is lacking. We randomly allocated 78 asthmatics to either a control or intervention group. Intervention consisted of two 2-h group sessions followed by 1-2 individual sessions each by a nurse and a physiotherapist. Self-management was emphasised following a stepwise treatment plan at exacerbations. Smokers experienced more general practitioner (GP) visits (P=0.001) and absenteeism from work (P=0.02), a greater need for rescue medication (P=0.03), a larger drop in FEV1 (P=0.02) and worse St. George's respiratory questionnaire (SGRQ) scores (P<0.001) compared to non-smokers during the 1-year follow-up. In multiple linear and logistic regression models smoking was still associated with worse SGRQ scores, a drop in FEV1, higher need for GP visits and rescue medication and higher total costs. We, thus, conclude that smoking was associated with reduced health related quality of life, a drop in FEV1, increased need for rescue medication and GP visits and higher costs after patient education during the 1-year follow-up, compared to no smoking.
authors.affiliation: Section of Pulmonary Medicine, Medical Department, Vest-Agder Central Hospital, Kristiansand, Norway. frode.gallefoss@vas.no
authors.forename: Frode
authors.initials: F
authors.lastname: Gallefoss
authors.forename: Per Sigvald
authors.initials: PS
authors.lastname: Bakke
mesh_terms: D000041:Absenteeism; D000328:Adult; D001249:Asthma / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D016022:Case-Control Studies; D017281:Cost of Illness; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009664:Norway; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000379:methods / Q000523:psychology; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires