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. 1996 Mar;46(404):169–171.

Do self-management plans reduce morbidity in patients with asthma?

G Hoskins 1, R G Neville 1, B Smith 1, R A Clark 1
PMCID: PMC1239578  PMID: 8731624

Abstract

BACKGROUND: Self-management plans may help patients with asthma intervene when symptoms deteriorate, thus preventing asthma attacks. AIM: A study set out to test whether a self-management plan tailored to the circumstances of the individual reduces morbidity from asthma. METHOD: General practitioners who had participated in a national audit of asthma attacks were randomized into intervention and control groups. Six months after the intervention group had issued self-management plans to patients with asthma, both groups of practitioners completed morbidity questionnaires on patients. Morbidity outcomes were compared for the 6-month periods before and after the issue of the plans. RESULTS: In the 6 months before the study, the 376 patients enrolled by the intervention group experienced higher levels of morbidity than the 530 patients for whom details were recorded by the control group. In the 6 months after the issue of the plans, control group patients showed little change in levels of morbidity, but intervention group patients showed significant reductions in hospital admissions, consultations for asthma symptoms, asthma review consultations, courses of oral steroids and use of emergency nebulized bronchodilators. CONCLUSION: General practitioners appeared to operate enthusiast bias' and issued more self-management plans to patients with uncontrolled asthma. The reduction in morbidity in this group is probably a result of the use of the plans, but the verdict on whether plans reduce morbidity must be deemed 'not proven'.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beasley R., Cushley M., Holgate S. T. A self management plan in the treatment of adult asthma. Thorax. 1989 Mar;44(3):200–204. doi: 10.1136/thx.44.3.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Charlton I., Antoniou A. G., Atkinson J., Campbell M. J., Chapman E., Mackintosh T., Schapira D. Asthma at the interface: bridging the gap between general practice and a district general hospital. Arch Dis Child. 1994 Apr;70(4):313–318. doi: 10.1136/adc.70.4.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Charlton I., Charlton G., Broomfield J., Mullee M. A. Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. BMJ. 1990 Dec 15;301(6765):1355–1359. doi: 10.1136/bmj.301.6765.1355. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fireman P., Friday G. A., Gira C., Vierthaler W. A., Michaels L. Teaching self-management skills to asthmatic children and their parents in an ambulatory care setting. Pediatrics. 1981 Sep;68(3):341–348. [PubMed] [Google Scholar]
  5. Hilton S., Sibbald B., Anderson H. R., Freeling P. Controlled evaluation of the effects of patient education on asthma morbidity in general practice. Lancet. 1986 Jan 4;1(8471):26–29. doi: 10.1016/s0140-6736(86)91904-5. [DOI] [PubMed] [Google Scholar]
  6. Jenkinson D., Davison J., Jones S., Hawtin P. Comparison of effects of a self management booklet and audiocassette for patients with asthma. BMJ. 1988 Jul 23;297(6643):267–270. doi: 10.1136/bmj.297.6643.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jones K. P., Charlton I. H., Middleton M., Preece W. J., Hill A. P. Targeting asthma care in general practice using a morbidity index. BMJ. 1992 May 23;304(6838):1353–1356. doi: 10.1136/bmj.304.6838.1353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kendrick A. H., Higgs C. M., Whitfield M. J., Laszlo G. Accuracy of perception of severity of asthma: patients treated in general practice. BMJ. 1993 Aug 14;307(6901):422–424. doi: 10.1136/bmj.307.6901.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Maiman L. A., Green L. W., Gibson G., MacKenzie E. J. Education for self-treatment by adult asthmatics. JAMA. 1979 May 4;241(18):1919–1922. [PubMed] [Google Scholar]
  10. Neville R. G., Clark R. C., Hoskins G., Smith B. National asthma attack audit 1991-2. General Practitioners in Asthma Group. BMJ. 1993 Feb 27;306(6877):559–562. doi: 10.1136/bmj.306.6877.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Osman L. M., Abdalla M. I., Beattie J. A., Ross S. J., Russell I. T., Friend J. A., Legge J. S., Douglas J. G. Reducing hospital admission through computer supported education for asthma patients. Grampian Asthma Study of Integrated Care (GRASSIC). BMJ. 1994 Feb 26;308(6928):568–571. doi: 10.1136/bmj.308.6928.568. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Partridge M. R. Asthma: guided self management. BMJ. 1994 Feb 26;308(6928):547–548. doi: 10.1136/bmj.308.6928.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sibbald B. Patient self care in acute asthma. Thorax. 1989 Feb;44(2):97–101. doi: 10.1136/thx.44.2.97. [DOI] [PMC free article] [PubMed] [Google Scholar]

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