Two short interventions to reduce health care requirements in asthma patients. A multicentre controlled study (ASTHMACAP II).
OBJECTIVE
Asthma control is suboptimal. The objective of this study was to reduce health care requirements and work absenteeism.


METHODS
Multicenter randomized controlled study investigating asthma control, educational parameters, health service use, and absenteeism. After adjusting treatment according to GINA recommendations, control group patients (CG) followed their physician's recommendations, while intervention group (IG) patients additionally underwent a 5-minute educational intervention. This protocol was repeated at 3 months, and a final assessment was carried out at 6 months.


RESULTS
479 patients (mean age 40 (SD 17) years) were recruited from primary care, and 334 completed the study. Comparatively, IG patients showed an improvement at the 3- and 6-month evaluations in the six educational parameters (P<0.001) and required fewer urgent visits to the GP for exacerbations [RR=0.49 (95% CI 0.26-0.90); P<0.04], and before the third evaluation, also in urgent GP visits [RR=0.25 (95% CI 0.12-0.52); P<0.001]. Before this third evaluation, IG had fewer scheduled visits to the GP [RR=0.48 (95% CI 0.28-0.82); P<0.003], and fewer visits to the primary care [RR=0.40 (95% CI 0.18-0.87); P<0.05], and to hospital emergency rooms [RR=0.13 (95% CI 0.04-0.42); P<0.001]. In addition, before the third evaluation, IG patients were less often absent from work [RR=0.22 (95% CI 0.05-0.98); P<0.03] or unable to work at home [RR=0.31 (95% CI 0.12-0.82); P<0.02].


CONCLUSIONS
Two short educational interventions improved asthma education and decreased the use of health resources and work absenteeism.
Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: fmorell@vhebron.net.
Ferran
F
Morell
Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Iñigo
I
Ojanguren
Servicio de Neumología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain.
Rosa
R
Cordovilla
Servicio de Neumología, Hospital de Galdakao, Vizcaya, Spain.
Isabel
I
Urrutia
Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Ramón
R
Agüero
Servicio de Neumología, Hospital Universitario Insular de Gran Canaria, Las Palmas, Gran Canaria, Spain.
Javier
J
Guerra
Centre d'Atenció Primària Sant Rafael, 08035 Barcelona, Spain.
Teresa
T
Genover
Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
Maria Antonia
MA
Ramon
D000041:Absenteeism; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058672:Adrenergic beta-2 Receptor Antagonists / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000523:psychology / Q000628:therapy*; D015992:Body Mass Index; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010174:Pamphlets; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods* / Q000458:organization & administration; D011320:Primary Health Care; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013030:Spain; D013147:Spirometry; D011795:Surveys and Questionnaires; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D058672:Adrenergic beta-2 Receptor Antagonists; D018927:Anti-Asthmatic Agents
Asma; Asma en atención primaria; Asthma; Asthma education; Asthma in primary care; Asthma management; Control del asma; Educación sobre el asma