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Limited (information only) patient education programs for adults with asthma
P G Gibson1, H Powell, J Coughlan
1Department of Respiratory and Sleep Medicine, John Hunter Hospital, Locked Bag 1, Hunter Mail Centre, NSW, Australia, 2310. mdpgg@mail.newcastle.edu.au
Background:
A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education.
Objectives:
The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma.
Search Strategy:
We searched the Cochrane Airways Group trials register and reference lists of articles.
Selection Criteria:
Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age.
Data Collection And Analysis:
Trial quality was assessed and two reviewers extracted data independently. Study authors were contacted for missing information.
Main Results:
Twelve trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no significant effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but in two studies, perceived asthma symptoms did improve after limited asthma education (odds ratio 0.44, 95% confidence interval 0.26 to 0.74). In one study, limited asthma education was associated with reduced emergency department visits (reduction of -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18).
Reviewer'S Conclusions:
Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma although perceived symptoms may improve. Provision of information in the emergency department may be effective, but this needs to be confirmed.