Limited (information only) patient education programs for adults with asthma

Abstract

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 methods

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).

Authors' 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.

Author(s)

Peter G Gibson, Heather Powell, Amanda Wilson, Michael J Hensley, Michael J Abramson, Adrian Bauman, E. Haydn Walters, Jennifer JL Roberts

Abstract

Plain language summary

Limited (information only) patient education programs for adults with asthma

Using a systematic approach, the medical literature was searched thoroughly to find reliable studies that looked at the effects of improving patients' knowledge about asthma, but which did not attempt to improve practical self‐management skills. The results of the studies were combined to see if patient education designed to improve patient knowledge about their condition made a difference to their asthma. Improving patient knowledge alone does not seem to reduce hospitalisations, doctor visits or medication use for asthma, but may play a role in improving patients perceptions of their symptoms. However, education programmes designed to improve knowledge alone may reduce Emergency Room visits in high‐risk adults.

Author(s)

Peter G Gibson, Heather Powell, Amanda Wilson, Michael J Hensley, Michael J Abramson, Adrian Bauman, E. Haydn Walters, Jennifer JL Roberts

Reviewer's Conclusions

Authors' conclusions 

Implications for practice 

1. Limited asthma education programmes that provide information only do not significantly reduce hospitalisations, doctor visits or medication use in asthma but may play a role in improving patients perceptions of their symptoms. - - 2. Limited asthma education (information only) programmes reduce ER visits in high‐risk adults.

Implications for research 

To facilitate efficacious health care policy it is recommended that a comparison of the cost effectiveness of limited asthma education (information only) and more intensive self‐management education programmes in Emergency Room be undertaken.

It is recommended that further investigation be undertaken to address whether limited asthma education (information only) satisfies the stated needs of patients for information about their disease.

There are opportunities to design and test the effects of brief interventions based on health behaviour change theory.

To minimise bias it is recommended that future studies consider the following methodological issues:

1. use a blinded method to generate a random sequence and state the method used;

2. state method used to conceal allocation to intervention(s) and control groups;

3. blind outcome assessors and state how they were blinded; and

4. use an 'active control'.

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