Evaluation of two different educational interventions for adult patients consulting with an acute asthma exacerbation

Asthma education decreases the number of emergency visits in specific subgr oups of patients with asthma. However, it remains unknown whether this impr ovement is related only to the use of an action plan alone or to other comp onents of the educational intervention. A total of 126 patients consulting urgently for an acute asthma exacerbation were recruited; 98 completed the study. The first 45 patients were assigned to Group C (control; usual treat ment). Thereafter, patients were randomized to either Group LE (limited edu cation; teaching of the inhaler technique plus self action plan given by th e on call physician) or Group SE (same as group LE plus a structured educat ional program emphasizing self-capacity to manage asthma exacerbations). At baseline, there was no difference between groups in asthma morbidity, medi cation needs, or pulmonary function. After 12 mo, only Group SE showed a si gnificant improvement in knowledge, willingness to adjust medications, qual ity of life scores, and peak expiratory flows. In the last 6 mo, the number of unscheduled medical visits for asthma was significantly lower in Group SE in comparison with groups C and LE (p = 0.03). The number (%) of patient s with unscheduled medical visits also decreased significantly in Group SE compared with Groups C and LE (p = 0.02). We conclude that a structured edu cational intervention emphasizing self-management improves patient outcomes significantly more than a limited intervention or conventional treatment.