Self-management education and regular practitioner review for adults with asthma.
By P. Gibson, H. Powell, J. Coughlan, A. Wilson, M. Abramson, P. Haywood, Adrian Bauman, M. Hensley, E. Walters. Cochrane Database of Systematic Reviews, 2002
1,302 citations recorded by the source corpus.
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. This review was conducted to examine the strength of evidence supporting Step 6 of the Australian Asthma Management Plan: "Educate and Review Regularly"; to test whether health outcomes are influenced by education and self-management programmes. OBJECTIVES The objective of this review was to assess the effects of asthma self-management programmes, when coupled with regular health practitioner review, 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 trials of self-management education in adults over 16 years of age with asthma. DATA COLLECTION AND ANALYSIS Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation. MAIN RESULTS Thirty six trials, which compared self-management education with usual care, were included. Self-management education reduced hospitalisations (relative risk 0.64, 95% confidence interval 0.50 to 0.82); emergency room visits (relative risk 0.82, 95% confidence interval (0.73 to 0.94); unscheduled visits to the doctor (relative risk 0.68, 95% confidence interval 0.56 to 0.81); days off work or school (relative risk 0.79, 95% confidence interval 0.67 to 0.93); nocturnal asthma (relative risk 0.67, 95% confidence interval 0.0.56 to 0.79); and quality of life (standard mean difference 0.29, confidence interval 0.11 to 0.47). Measures of lung function were little changed. REVIEWER'S CONCLUSIONS Education in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan improves health outcomes for adults with asthma. Training programmes that enable people to adjust their medication using a written action plan appear to be more effective than other forms of asthma self-management.
Subfields: Endocrinology, Diabetes and Metabolism, Physiology, Pulmonary and Respiratory Medicine
View Paper: https://www.semanticscholar.org/paper/999a0b9f43974d38b5f9875a0eb324bf696932b5
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
In Physiology
In Pulmonary and Respiratory Medicine
Citations in the corpus
- Changing Illness Perceptions After Myocardial Infarction: An Early Intervention Randomized Controlled Trial (2002, background): “A recent systematic review of asthma patients, eg, has shown that patients who had a personalized written plan were more adherent to medication, less likely to be hospitalized, and had better lung function than those who did not have a personalized plan (11).”
- Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective (2020, background): “…to assess an upper respiratory infection, blood pressure for hypertension (Noah et al., 2018), peak-flow lung capacities for chronic obstructive pulmonary disease (Kaptein et al., 2014) and asthma (Gibson et al., 2003; Kaptein et al., 2014), and blood glucose for diabetes (Vas et al., 2017).”
- Self-regulation and Self-management in Asthma: Exploring The Role of Illness Perceptions and Treatment Beliefs in Explaining Non-adherence to Preventer Medication (2002, background): “A recent systematic review concluded that ‘training in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and written action plans, appears to improve health outcomes for adults with asthma’ (Gibson et al., 2000).”
- A summary of the new GINA strategy: a roadmap to asthma control (2015, background): “…ICS comprise most of the strong evidence base that continues to support recommendations for asthma self-management and written asthma action plans [62]; action plans which include both increased ICS (usually doubling) and oral corticosteroids (OCS) consistently improve health outcomes but there…”
- Is There Time for Management of Patients With Chronic Diseases in Primary Care? (2005, neutral): “4) 8 2 10 587 Hypertension 472 312 (66) 160 (34) 12 2 10 704 Depression 118 58 (49) 60 (51) 12 4 10 156 Asthma 183 62 (33.”