Asthma education, monitoring and environmental control

Asthma treatment in the last 10 years has benefited greatly from the first and second reports of the National Asthma Education and Prevention Program expert panel. Newer approaches to medical therapy have been accompanied by more aggressive attempts to involve patients in the management of their dis ease. In fact, it is widely recognized that the patient has a very importan t role in asthma management. As indicated by the section title, symptom and peak flow monitoring, along with environmental control, are essential topi cs for patient education. This review covers the three related areas of edu cation, monitoring and environmental control, as well as the associated sal ient issues addressed in recent asthma prevention and control literature. T he first section covers essential elements of asthma education. A review of current research and recommendations includes a brief synopsis of the expe rt panel recommendations for patient and family education and summarizes re cent controlled trials of asthma self management interventions for both chi ldren and adults. The results of these trials raise the question of increme ntal gains in patient outcomes seen with increasing intensity of asthma sel f management interventions. Suggestions for future directions for self mana gement research are included in this and the following two sections. The se cond section focuses primarily on research related to the role of self moni toring in asthma care and the relative advantages of using a peak flow mete r and/or symptoms to assess the need for a step up in treatment. The final section addresses environmental control as it relates to self management an d looks at the burgeoning literature on the role of household environmental monitoring and control for the prevention of sensitization and subsequent morbidity from exposure to allergens and irritants. The importance of the p atient and family in environmental control is emphasized. (C) 1999 Prous Sc ience. All rights reserved.