Short-term effectiveness of an asthma educational program: results of a randomized controlled trial

Abstract

Asthma educational programs have been shown to reduce the use of emergency room, frequency of severe asthma attacks and hospitalization. However, its effectiveness in other morbidity parameters and on quality of life has yet to be fully understood. This prospective randomized control trial evaluated the effectiveness of a patient education program in 77 asthmatics according to "Teach Your Patients About Asthma: A Clinicians Guide" (1992). Forty asthmatic patientswere randomly allocated to Group A (usual treatment) and 37 to Group B (usual treatment plus a patient education program). The effectiveness of the educational program was evaluated by comparing morbidity outcomes at baseline and 3 months after initial evaluation. At enrolment, the two groups were not different with regard to age, sex, smoking, asthma severity atopy, FEV1, symptom-free days, use of rescue salbutamol and quality of life. Three months later, subjects in Group B showed a significant improvement in the overall quality of life (p < 0.01) and in the "Symptoms"domain (p < 0.01). None of the other parameters (use of rescue salbutamol, symptom-free days, days absent from work or school, FEV1) showed any significant change. After stratification for asthma severity, only subjects with moderate-to-severe asthma showed a significant improvement inthe overall qualityof life (p < 0.05) and in the "Symptoms" (p < 0.01) and 'Activities" (< 0.05) domains. Moreover, in subjects with moderate-to-severe asthma FEV1 value at the 3rd month of follow-up was higher in Group B than in Group A (p < 0.05). In conclusion, the educational program improved the quality of life in asthratic subjects, mainly in patients with moderate-to-severe asthma.

Does an Asthma Education Program Improve Quality of Life? A Two-Year Randomized Trial

“…NNT values at 1 year of follow-up ranged from 7.7 to 10 in all domains but the ''Emotions.'' These values were higher than what was found in the same cohort 3 months after the education program (from 3.1 to 4.3) (14), suggesting the positive effect of the education program tends to be lost over time. In fact, at 2 years of follow-up, no clinical benefit could be demonstrated.…”

“…Although a positive effect on QoL of education programs lasting for up to 1 year of follow-up has often been reported (4,5,12,14), whether the benefit persists in the long term has seldom been investigated (3,12). Kelso et al (12) and Kauppinen et al (3) demonstrated a QoL improvement lasting for 2 and 5 years, respectively, after an education program.…”

“…In a prospective controlled trial we recently showed that an asthma education program was rapidly effective in improving QoL (14). The aim of the present study was to evaluate the effectiveness of this program on morbidity outcomes and on QoL over 2 years.…”

Psychological treatment of comorbid asthma and panic disorder: A pilot study

“…The effect size was large in both protocols (Table 2), higher in the 14-session protocol. In asthma education programs, improvement in this measure has tended to be minimal (Marabini et al, 2002(Marabini et al, , 2005.…”

“…The effect size for the follow-up assessment (0.9 in the 14-session protocol and 1.1 in the eight-session protocol) was smaller than that reported by O'Byrne et al (d = 2.2) in a multi-center trial of formeterol treatment among asthma patients already taking inhaled corticosteroid therapy, a drug therapy taken by almost all patients in our study. However, no decreases at all are found for albuterol use in several asthma education programs (Grampian Asthma Study of Integrated Care, 1994;Marabini et al, 2002Marabini et al, , 2005Perneger et al, 2002), (where most asthma patients did not have panic disorder, nor did they necessarily overuse bronchodilators), although one study did report a significant decrease in abluterol use (Gani et al, 2001).…”