Clinical studyEffect of patient education on self-management skills and health status in patients with asthma: a randomized trial☆
Section snippets
Program description
The educational intervention was based on the theoretical framework of self-regulation (22), which postulates that patients have symptomatic impairment, choose among possible solutions, apply the selected strategy, and evaluate its results. The program was based on the assumption that reinforcement mechanisms, such as providing feedback on treatment and sharing responsibility for care with patients and their families, would improve coping with asthma and increase adherence to recommended
Results
Only about half of eligible patients agreed to participate (Figure). Most participants had asthma for more than 10 years and had been hospitalized before enrollment (Table 1). About 30% reported having received asthma education previously. At baseline, the two treatment groups had similar characteristics (Table 1).
In the immediate-education group, only 35 patients (53%) attended all three scheduled sessions, 11 patients (17%) attended two sessions, 6 patients (9%) attended one session, and 14
Discussion
Patients hospitalized with asthma benefited only moderately from the education program that we evaluated. Although most patient outcomes improved significantly between baseline and follow-up among patients in the immediate-education group, similar improvements also occurred among those on the waiting list. Only a handful of variables differed significantly between the two groups. Hence, few favorable outcomes could be attributed to the education program. Had we applied a correction for multiple
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Comparative Efficacy of Strategies to Support Self-Management in Patients with Asthma: A Systematic Review and Network Meta-Analysis
2022, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Approximately half of the included studies (20 studies)26-28,30,31,33,35,36,39,40,42,43,49-53,56,57,59 were classified as being of low risk of bias for allocation sequence generation because they clearly described appropriate random number generation, whereas the remaining 15 trials25,29,32,34,37,38,41,44-48,54,55,58 did not specify the random allocation process. Considering the risk of bias for allocation concealment, 17 studies25,28,30,32,33,35,36,40,42,43,49-52,54,56,59 reported some form of centralized randomization scheme, the use of sealed opaque envelopes or other appropriate allocation concealment approaches, whereas 18 studies26,27,29,31,34,37-39,41,44-48,53,55,57,58 were deemed as being of unclear risk of bias because information regarding this issue was not identified. A total of 22 studies25,29,31,32,36-41,43-48,50-52,54,55,58 that measured objective outcomes such as hospitalizations, ED visits, and %pFEV1 were justified as being of low risk of bias for the “prevent knowledge allocation” domain.
Action plans and quality of life evaluations
2022, Allergic and Immunologic Diseases: A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic DiseasesWritten personalized action plan in atopic dermatitis: A therapeutic education tool
2014, Archives de PediatrieAssessment of patient needs to design a patient education program in systemic lupus erythematosus
2014, Revue de Medecine InterneModifiable factors associated with severe asthma exacerbations in urban patients
2012, Annals of Allergy, Asthma and ImmunologyRandomized trial of self-management education in asthmatic patients and effects of depressive symptoms
2010, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :The intervention seemed to provide some additional benefit in the early phase of the trial, when patients received weekly telephone reinforcements; however, this benefit waned with time as the weekly contacts ceased. The present findings are consistent with those of other studies in which controls derived benefit from increased asthma-related attention4,6–8 and effects of interventions diminished with time in the absence of specific reinforcements or boosters.26 Of the independent variables we measured, depressive symptoms was the one most consistently associated with worse outcomes.
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This study was supported by Grant 32-39701.93 from the Swiss National Science Foundation, Berne, Switzerland.