[Economic considerations of patient education]

The aim of this review is to analyse the economic impact of patient education programmes for asthma management and to compare methodologically the published economic evaluations for asthma programmes.

An extended MEDLINE research identified 15 economic evaluations of asthma patient education programmes for the period 1981 to 1996. These studies were analysed regarding their overall results and their methodological quality using the criteria of Drummond et al. (1987).

The economic and methodological results of the analysed asthma programmes show a wide variation. Some programmes result in higher costs (3 out of 15), but most of the published studies show a positive benefit-cost ratio for the implementation of an asthma patient education programme (10/15). Only 1/3 (5 out of 15) of the published studies fulfil at least 2/3 of the criteria of Drummond et al. (1987). One potential reason for the varying results are the different inclusion criteria for patients and cost categories.

Patient education in chronic diseases such as asthma is a well recognised, effective and efficient component of a modern approach to disease management. The economic impact is nonetheless related to the design of the programme, the patient selection criteria, and the perspective of the analyses. Only some of the economic evaluations analysed in this review fulfil at least 2/3 of the methodological criteria for good economic practice. Future economic evaluations of patient education programmes should follow the published methodological standards more strictly.