INFLUENCE ON ASTHMA MORBIDITY OF ASTHMA EDUCATION-PROGRAMS BASED ON SELF-MANAGEMENT PLANS FOLLOWING TREATMENT OPTIMIZATION

The objective of this study was to evaluate the effectiveness of an as thma education program on morbidity, knowledge, and compliance with in haled corticosteroid treatment using a prospective, randomized, contro lled, one-year-before/one-year-after protocol. After rigorous optimiza tion of asthma therapy under the care of respirologists, patients were assigned to one of three groups: Group C (control group: no formal ed ucation), Group P (education and action plan based on peak-flow monito ring), and Group S (education with action plan based on monitoring of asthma symptoms). A total of 188 subjects with moderate to severe asth ma were enrolled and 149 completed the study. asthma morbidity decreas ed significantly in all groups (p = 0.001). Mean values one-year-befor e/one-year-after in Groups C, P, and S were: unscheduled medical visit s, 2.4/0.8, 2.3/0.7, and 1.9/0.7; hospitalizations, 0.21/0.04, 0.24/0. 04, and 0.40/0.09; oral steroid treatments; 1.3/0.5, 1.2/0.7, and 1.3/ 0.9; absenteeism from work/school, 9.6/5.2, 8.8/2.2, and 6.3/2.9. Betw een-group differences did not reach statistical significance (p > 0.05 ). Asthma knowledge increased in both educated groups compared with th e control group (p < 0.001) as did short-term compliance with inhaled corticosteroids. These results confirm that treatment optimization cou pled with sustained high quality care in motivated patients can lead t o a significant decrease in asthma morbidity. In such clinical setting s, structured asthma education significantly improved short-term compl iance with treatment and knowledge about asthma, although it could not add extra benefit with regard to morbidity. Nevertheless, this study does not refute the potential benefit of educational interventions aim ed at improving asthma-related morbidity over a longer time period or in patients with less optimal care or with high-risk factors.