Controlled trial evaluation ofan asthma education programme foradults

Background-To improveasthmacontroland reducereadmission rates throughincreased knowledge and the development ofself managementskills, a brief(three hour)adulteducation programmewasdeveloped. Methods-Thecoursewas designed to improveinhaler skills andtoteachhow toadjust drugdosesaccording topeak flow(PEF)measurements anda treatmentplan.Itwasevaluated ina randomisedcontrolled trial in76patients admitted tohospital forasthmabyusing questionnaires, spirometry, and home monitoring ofPEF atentryandatfive and10monthsafterintervention. The questionnaire providedmeasuresof knowledge aboutasthma,selfmanagementbehaviour appropriate toasthma control, asthmasymptomfrequency and severity, andpsychosocial disturbance attributable toasthma. Results-During the10monthsobservationperiod thereadmission rateforthe educated groupwasoneseventh thatof thecontrolgroupand attendance at accident and emergencydepartments alsodecreased. Noconsistent differential improvements wereobserved inspirometricresults, averagePEF,ormean dailyvariability ofPEF.Bothgroups showedimprovements inmeasuresof asthmaknowledge, behaviour, symptoms,and psychosocial disturbances. However, theintervention groupshowed a significantly greater improvement in somemeasuresofasthmaknowledge and self managementskills. Conclusion-Despite minimaleffect on measuresofairway function, substantial changes inillness behaviour anduseof health carefacilities canbeachieved bya brief asthmaeducation programme.