Reduction in asthma morbidity following a community-based asthma self-management programme in Tonga.
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.
Foliaki
S
S
Ministry of Health, Nuku'alofa, Kingdom of Tonga. S.Foliaki@massey.ac.nz
Fakakovikaetau
T
T
D'Souza
W
W
Latu
S
S
Tutone
V
V
Cheng
S
S
Pearce
N
N
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
D000420:Albuterol