Group plus individual education improved quality of life and lung function in patients with asthma

Abstract

Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999 Mar;159:812-7. QuestionDoes an education programme improve health related quality of life and lung function in patients with mild to moderate asthma or chronic obstructive pulmonary disease (COPD)? DesignRandomised, single blind (blinded assessment of spirometry results), controlled trial with follow up at 12 months. SettingAn outpatient chest clinic at a hospital in Norway. Patients140 consecutive patients (mean age 49 y, 61% women) with bronchial asthma or COPD who were 18-70 years of age and did not have unstable ischaemic heart disease, heart failure, serious hypertension, diabetes mellitus, or kidney or liver failure. Patients with asthma had to have ≥ 80% of predicted forced expiratory volume at 1 second (FEV 1 ) in stable phase and 1 of a positive reversibility test, documented 20% spontaneous variability (peak expiratory flow and FEV 1 ), or a positive metacholine test. Patients with COPD had to have ≥ 40% and < 80% of predicted FEV 1 . Follow up was 89%. Intervention39 patients with asthma and 31 patients with COPD were allocated to receive the intervention; 39 patients with asthma and 31 patients with COPD were allocated to the control group. Separate sessions were held for patients with asthma and those with COPD. The intervention consisted of two 2 hour group sessions and 1-2 40 minute individual sessions with a nurse and 1-2 40 minute individual sessions with a physiotherapist. Group session 1 was led by a physician, who discussed self care, basic physiology, and prevention of attacks; group session 2 was led by a pharmacist who addressed asthma drugs; in the individual sessions, a nurse focused on self care and a physiotherapist addressed topics such as respiration during exacerbations, pursed lip breathing, rest positions, and relaxation exercises. These sessions focused on establishing a partnership with the patient and repeating the essentials of the group sessions with a more individualised approach; individualised care plans were given to patients at the final session. Patients in the control group received usual care from their general practitioner. Main outcome measuresHealth related quality of life as assessed by the St George's Respiratory Questionnaire (SGRQ) (76 items, weighted to produce component scores for symptoms, activity, and impact, and a total score of overall respiratory health) and FEV 1 assessed using spirometry. Main resultsAt 1 year, patients with asthma who received the intervention had better health related quality of life (mean 16.3 unit difference in SGRQ scores, p < 0.001) and a higher mean FEV 1 (increase of 3.4% v decrease of 2.7%, p < 0.05) than patients in the control group. For patients with COPD, the intervention and control groups did not differ for health related quality of life or FEV 1 . ConclusionAn education programme that included both group and individual sessions improved health relate...

The Effects of Asthma Education on Asthma Knowledge and Health-Related Quality of Life in Taiwanese Asthma Patients

“…Margareta, Anna, Mikael, and Christer (2009) showed that educational interventions by asthma nurses did effectively reduce the number of emergency department visits for asthma attacks by asthma patients. This randomized study of patients with asthma (N = 140) aged 18Y70 years showed that educated patients improved their health-related quality of life (HRQOL) scores compared with those who had not received tailored asthma education (Harper, & Wizowski, 1999). Patients whose intensive outpatient treatment also included an educational component had fewer readmissions during the following year (Scullion, 2004).…”