Benefit from the inclusion of self-treatment guidelines to a self-management programme for adults with asthma

This study assessed the long-term efficacy of adding self-treatment guideli nes to a self-management programme for adults with asthma. In this prospective randomized controlled trial, 245 patients with stable, moderate to severe asthma were included. They were randomized into a self-t reatment group (group S) and a control group (group C). Both groups received self-management education. Additionally, group S recei ved self-treatment guidelines based on peak expiratory flow (PEF) and sympt oms. Outcome parameters included: asthma symptoms, quality of life, pulmona ry function, and exacerbation rate. The 2-yr study mas completed by 174 pat ients. Both groups showed an improvement in the quality of life of 7%, PEF variability decreased by 32% and 29%, and the number of outpatient visits b y 25% and 18% in groups S and C, respectively. No significant differences i n these parameters were found between the two groups. After 1 yr, patients in both groups perceived better control of asthma and had more self-confide nce regarding their asthma. The latter improvements were significantly grea ter in group S as compared to group C. There were no other differences in o utcome parameters between the groups. Individual self-treatment guidelines for exacerbations on top of a general selfmanagement programme does not seem to be of additional benefit in terms of improvements in the clinical outcome of asthma. However, patients in th e self-treatment group had better scores in subjective outcome measures suc h as perceived control of asthma and self-confidence than patients in the c ontrol group.