title: Asthma outpatient education by multiple implementation strategy. Outcome of a programme using a personal notebook.
abstract: More than 10 years after publication, international guidelines remain poorly implemented. To better implement them, we need to develop new strategies adapted to the expectations of patients and health professionals outside hospital settings and to ensure better outpatient follow up in the community. We developed a bilingual education programme including a brochure designed to support an interdisciplinary health care network and measured hospitalisations (H), work absenteeism (WA), emergency visits (EV), asthma medication (AM) and quality of life (QL Juniper) before and 12 months after the intervention. All QL scores improved significantly in comparison with pre-intervention values. Health service use decreased dramatically when comparing the 12 months prior to and after the intervention(H: 35-8%, WA: 39-14%, EV: 88-53%). The final cost/benefit ratio of the programme was 1.96. Interdisciplinary implementation strategy of patient education is cost-effective, improves quality of life for asthmatics, and reduces strain on health services. Such a health care network does not require an expensive infrastructure and is better adapted to the reality and competences of clinical practice.
authors.affiliation: Centre Valaisan de pneumologie et Groupe d'éducation respiratoire, 3963 Crans-Montana, Switzerland. jean-marie.tschopp@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: J-P
authors.initials: JP
authors.lastname: Janssens
authors.forename: C
authors.initials: C
authors.lastname: Burrus
authors.forename: S
authors.initials: S
authors.lastname: Garrone
authors.forename: R
authors.initials: R
authors.lastname: Pernet
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: Rosset
authors.forename: J-P
authors.initials: JP
authors.lastname: Assal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000534:rehabilitation*; D003153:Community Health Services / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010045:Outpatients / Q000523:psychology; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods*; D015397:Program Evaluation / Q000379:methods; D011788:Quality of Life; D012720:Severity of Illness Index