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. 1999 Jun;54(6):493–500. doi: 10.1136/thx.54.6.493

Evaluation of a randomised controlled trial of adult asthma education in a hospital setting

O Abdulwadud 1, M Abramson 1, A Forbes 1, A James 1, E Walters 1
PMCID: PMC1745497  PMID: 10335002

Abstract

BACKGROUND—Although patient education is a key step in the Australian Asthma Management Plan, its impact has not been assessed in a hospital outpatient asthma clinic.
METHODS—A controlled trial was undertaken in 125 adults with asthma recruited from the Alfred Hospital Asthma and Allergy Clinic and randomly allocated to an intervention (n = 64) or control (n =61) group. Subjects in the intervention group attended three education sessions, each of 90 minutes duration, spread over three successive weeks. Asthma knowledge, quality of life, self-management skills, and attitudes and beliefs about asthma were assessed by questionnaires at baseline and after six months. The intervention group was also assessed immediately after the three education sessions. The control group was evaluated after six months of usual care.
RESULTS—Asthma knowledge improved significantly in the intervention group after three education sessions (p = 0.0001) and this was retained six months later (p = 0.03). The impact of asthma on quality of life decreased significantly immediately after intervention (p = 0.03) but this was not maintained six months later (p = 0.35). On the other hand, the intervention had little impact on self-management skills or attitudes and beliefs about asthma. However, the control group had also improved their knowledge, quality of life and self-management skills after six months of usual care. The difference in mean change in knowledge score at six months between the intervention and control groups was not significant (p = 0.51).
CONCLUSIONS—In contrast to some other studies, a limited asthma education programme in a hospital outpatient setting had a positive impact on patients' knowledge of asthma, but not on their quality of life, self-management skills, or attitudes and beliefs about asthma.



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Selected References

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  1. Abdulwadud O., Abramson M., Forbes A., James A., Light L., Thien F., Walters E. H. Attendance at an asthma educational intervention: characteristics of participants and non-participants. Respir Med. 1997 Oct;91(9):524–529. doi: 10.1016/s0954-6111(97)90085-8. [DOI] [PubMed] [Google Scholar]
  2. Abramson M., Kutin J., Bowes G. The prevalence of asthma in Victorian adults. Aust N Z J Med. 1992 Aug;22(4):358–363. doi: 10.1111/j.1445-5994.1992.tb02148.x. [DOI] [PubMed] [Google Scholar]
  3. Allen R. M., Jones M. P., Oldenburg B. Randomised trial of an asthma self-management programme for adults. Thorax. 1995 Jul;50(7):731–738. doi: 10.1136/thx.50.7.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Campbell D. A., McLennan G., Coates J. R., Frith P. A., Gluyas P. A., Latimer K. M., Luke C. G., Martin A. J., Roder D. M., Ruffin R. E. A comparison of asthma deaths and near-fatal asthma attacks in South Australia. Eur Respir J. 1994 Mar;7(3):490–497. doi: 10.1183/09031936.94.07030490. [DOI] [PubMed] [Google Scholar]
  5. D'Souza W. J., Te Karu H., Fox C., Harper M., Gemmell T., Ngatuere M., Wickens K., Crane J., Pearce N., Beasley R. Long-term reduction in asthma morbidity following an asthma self-management programme. Eur Respir J. 1998 Mar;11(3):611–616. [PubMed] [Google Scholar]
  6. Forero R., Bauman A., Young L., Larkin P. Asthma prevalence and management in Australian adolescents: results from three community surveys. J Adolesc Health. 1992 Dec;13(8):707–712. doi: 10.1016/1054-139x(92)90068-m. [DOI] [PubMed] [Google Scholar]
  7. Garrett J., Fenwick J. M., Taylor G., Mitchell E., Stewart J., Rea H. Prospective controlled evaluation of the effect of a community based asthma education centre in a multiracial working class neighbourhood. Thorax. 1994 Oct;49(10):976–983. doi: 10.1136/thx.49.10.976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gibson J., Gallagher H., Johansen A., Webster I. Lung function in an Australian population: 1. Spirometric standards for non-smoking adults. Med J Aust. 1979 Apr 7;1(7):292–295. doi: 10.5694/j.1326-5377.1979.tb112111.x. [DOI] [PubMed] [Google Scholar]
  9. Kolbe J., Vamos M., James F., Elkind G., Garrett J. Assessment of practical knowledge of self-management of acute asthma. Chest. 1996 Jan;109(1):86–90. doi: 10.1378/chest.109.1.86. [DOI] [PubMed] [Google Scholar]
  10. Krahn M. D., Berka C., Langlois P., Detsky A. S. Direct and indirect costs of asthma in Canada, 1990. CMAJ. 1996 Mar 15;154(6):821–831. [PMC free article] [PubMed] [Google Scholar]
  11. Lahdensuo A., Haahtela T., Herrala J., Kava T., Kiviranta K., Kuusisto P., Perämäki E., Poussa T., Saarelainen S., Svahn T. Randomised comparison of guided self management and traditional treatment of asthma over one year. BMJ. 1996 Mar 23;312(7033):748–752. doi: 10.1136/bmj.312.7033.748. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Madge P., McColl J., Paton J. Impact of a nurse-led home management training programme in children admitted to hospital with acute asthma: a randomised controlled study. Thorax. 1997 Mar;52(3):223–228. doi: 10.1136/thx.52.3.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Maes S., Schlösser M. Changing health behaviour outcomes in asthmatic patients: a pilot intervention study. Soc Sci Med. 1988;26(3):359–364. doi: 10.1016/0277-9536(88)90401-7. [DOI] [PubMed] [Google Scholar]
  14. Marks G. B., Dunn S. M., Woolcock A. J. A scale for the measurement of quality of life in adults with asthma. J Clin Epidemiol. 1992 May;45(5):461–472. doi: 10.1016/0895-4356(92)90095-5. [DOI] [PubMed] [Google Scholar]
  15. Marks G. B., Mellis C. M., Peat J. K., Woolcock A. J., Leeder S. R. A profile of asthma and its management in a New South Wales provincial centre. Med J Aust. 1994 Mar 7;160(5):260-4, 268. [PubMed] [Google Scholar]
  16. Mellis C. M., Peat J. K., Bauman A. E., Woolcock A. J. The cost of asthma in New South Wales. Med J Aust. 1991 Oct 21;155(8):522–528. doi: 10.5694/j.1326-5377.1991.tb93888.x. [DOI] [PubMed] [Google Scholar]
  17. Robertson C. F., Rubinfeld A. R., Bowes G. Deaths from asthma in Victoria: a 12-month survey. Med J Aust. 1990 May 21;152(10):511–517. doi: 10.5694/j.1326-5377.1990.tb125350.x. [DOI] [PubMed] [Google Scholar]
  18. Sibbald B., Collier J., D'Souza M. Questionnaire assessment of patients' attitudes and beliefs about asthma. Fam Pract. 1986 Mar;3(1):37–41. doi: 10.1093/fampra/3.1.37. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. Snyder S. E., Winder J. A., Creer T. J. Development and evaluation of an adult asthma self-management program: Wheezers Anonymous. J Asthma. 1987;24(3):153–158. doi: 10.3109/02770908709070931. [DOI] [PubMed] [Google Scholar]
  21. Woolcock A., Rubinfeld A. R., Seale J. P., Landau L. L., Antic R., Mitchell C., Rea H. H., Zimmerman P. Thoracic society of Australia and New Zealand. Asthma management plan, 1989. Med J Aust. 1989 Dec 4;151(11-12):650–653. [PubMed] [Google Scholar]
  22. Yoon R., McKenzie D. K., Bauman A., Miles D. A. Controlled trial evaluation of an asthma education programme for adults. Thorax. 1993 Nov;48(11):1110–1116. doi: 10.1136/thx.48.11.1110. [DOI] [PMC free article] [PubMed] [Google Scholar]

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