How does patient education and self-management among asthmatics and patients with chronic obstructive pulmonary disease affect medication?

The effect of patient education on steroid inhaler compliance and rescue me dication utilization in patients with asthma or chronic obstructive pulmona ry disease (COPD) has not been previously investigated in a single study. W e randomized 78 asthmatics and 62 patients with COPD after ordinary outpati ent management. Intervention consisted of two 2-h group sessions and 1 to 2 individual sessions by a trained nurse and physiotherapist. A self-managem ent plan was developed. We registered for 12 mo medication dispensed from p harmacies according to the Anatomical Therapeutic Chemical (ATC) classifica tion index. Steroid inhaler compliance (SIC) was defined as (dispensed/pres cribed) x 100 and being compliant as SIC > 75%, Among asthmatics 32% and 57 % were compliant (p = 0.04) with a median (25th/75th percentiles) SIC of 55 % (27/96) and 82% (44/127) (p = 0.08) in the control and intervention group s, respectively. Patient education did not seem to change SIC in the COPD g roup. Uneducated patients with COPD were dispensed double the amount of sho rt-acting inhaled beta(2)-agonists compared with the educated group (p = 0. 03). We conclude that patient education can change medication habits by red ucing the amount of short-acting inhaled beta(2)-agonists being dispensed a mong patients with COPD. Educated asthmatics showed improved steroid inhale r compliance compared with the uneducated patients, whereas this seemed una ffected by education in the COPD group.