title: Reduction in asthma morbidity following a community-based asthma self-management programme in Tonga.
abstract: BACKGROUND
  The Tonga Asthma Self-management Project assessed whether the introduction of an asthma self-management plan would reduce asthma morbidity.
  
  
  METHODS
  The project involved a 'before and after' trial, with each participant serving as his/her own control. Asthma patients used the self-management plan to manage their asthma medication or obtain medical help based on their peak expiratory flow (PEF) rate and/or asthma symptoms.
  
  
  RESULTS
  The 110 participants initially had relatively high asthma morbidity: 68% had had an emergency medical visit for asthma in the previous 12 months. Ninety-two (84%) completed the 12-month programme. Emergency doctor visits fell from 66% in the previous 12 months to 18% (P < 0.001) in the following 12 months. Other measures also improved, including hospital admissions (from 19% to 3%, P = 0.001), having 14 days or more 'out of action' (from 29% to 4%, P < 0.001), waking > or = 2 nights a week (from 40% to 13%, P < 0.001), severe asthma attacks (from 54% to 18%, P < 0.001) and mean PEF rates (from 341 l/min to 417 l/min, a 22% increase, P < 0.001).
  
  
  CONCLUSIONS
  The potential benefits of asthma self-management plans and community-based asthma education are supported by the findings of the Tonga study. Their implementation is essential in the resource-scarce Pacific health setting.
authors.affiliation: Ministry of Health, Nuku'alofa, Kingdom of Tonga. S.Foliaki@massey.ac.nz
authors.forename: S
authors.initials: S
authors.lastname: Foliaki
authors.forename: T
authors.initials: T
authors.lastname: Fakakovikaetau
authors.forename: W
authors.initials: W
authors.lastname: D'Souza
authors.forename: S
authors.initials: S
authors.lastname: Latu
authors.forename: V
authors.initials: V
authors.lastname: Tutone
authors.forename: S
authors.initials: S
authors.lastname: Cheng
authors.forename: N
authors.initials: N
authors.lastname: Pearce
mesh_terms: D000293:Adolescent; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control*; D002648:Child; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data; D010366:Peak Expiratory Flow Rate; D012648:Self Care; D014058:Tonga; D055815:Young Adult
chemical_list: D000420:Albuterol