Use of biological markers of airway inflammation to detect the efficacy ofnurse-delivered asthma education

OBJECTIVE: The purpose of this study was to determine whether analysis of t he constituents of induced sputum could be used to document the efficacy of a nurse-delivered patient education intervention and whether changes in th e biological markers of inflammation in sputum would correlate with improve ments in pulmonary function and symptoms. DESIGN: The study design was prospective, open trial with repeated measures . SETTING: The study took place at a West Coast academic medical center labor atory. SUBJECTS: Subjects included 12 nonsmoking persons with asthma, ages 23 to 5 1 years, on prescribed daily anti-inflammatory inhaled therapy who had not required oral prednisone in the previous 4 weeks of enrollment. METHOD: The effect of one 30-minute asthma education session on spirometry, peak flow, symptoms, and biological markers of inflammation in sputum was tested for 8 weeks to determine whether biological markers reflect the effi cacy of educational interventions. RESULTS: Mean symptom scores decreased and lung function increased slightly over 8 weeks. Markers of eosinophil degranulation decreased by 50% and alb umin by 25% from baseline to 8 weeks. Eosinophil percentages dropped 20% ov er time but did not change consistently at all Lime points. Clinical marker s of asthma control correlated in the low-to-moderate range with biological markers of air way inflammation. CONCLUSION: The results of this study show the effects of a patient educati on intervention carl be detected in both clinical and biological outcomes. Individual education may influence self-care of asthma including adherence to inhaled corticosteroid therapy and thereby suppress airway inflammation.