Clinical studyEffects of individual self-management education on clinical, biological, and adherence outcomes in asthma☆
Section snippets
Study design
We conducted a prospective, randomized controlled trial of an individually delivered asthma educational self-management intervention in adults with mild-to-moderate asthma who were treated with an inhaled corticosteroid. We assessed adherence with inhaled corticosteroid medication using an electronic recording device (Doser; NewMed Corp., Newton, Massachusetts); the intensity of airway inflammation by measuring the constituents of induced sputum; and asthma control by measuring the frequency of
Results
Of 224 adults with asthma who were screened, 68 met study criteria, gave written informed consent, and were enrolled in the study. The most common reasons for exclusion were a history of smoking or inadequate bronchial hyperresponsiveness to inhaled methacholine. Two subjects (1 in each group) developed asthma exacerbations during the study and withdrew, and 1 (in the control group) withdrew because of time constraints. The final sample included 65 subjects: 62 with complete data for all time
Discussion
Our results suggest that asthma education is beneficial, even among patients who monitor their asthma. Although the subjects in the control group recorded peak flow and completed diaries as often as did subjects in the intervention group, they did not improve adherence to inhaled corticosteroids. However, the control group did not wane in adherence, as has been seen in recent observational studies 22, 23. Indeed, compliance was often better than expected in clinical trials, which may account
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Cited by (72)
Action plans and quality of life evaluations
2022, Allergic and Immunologic Diseases: A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic DiseasesPersonalized Medication Adherence Management in Asthma and Chronic Obstructive Pulmonary Disease: A Review of Effective Interventions and Development of a Practical Adherence Toolkit
2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Two studies were identified as eligible from the reference lists, but were not included.16,17 One study evaluated the same intervention in two separate studies; of those, we included one (the largest study with a longer follow-up).16 Another study evaluated the same intervention: one study had a control group (which we included), and in the second study, the intensity of interventions was different between groups.17
National standards for asthma self-management education
2015, Annals of Allergy, Asthma and ImmunologyAssociations of patient outcomes with level of asthma control
2012, Annals of Allergy, Asthma and ImmunologyModifiable factors associated with severe asthma exacerbations in urban patients
2012, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :However, this is the first study to control for multiple modifiable factors, including perceived barriers to care, asthma knowledge, and attitudes toward asthma management. In regard to asthma education programs, previous trials have shown mixed results in improvement of outcomes,12,28–34 although few of these trials have included self-efficacy training in their curriculum. Previous educational interventions that included self-efficacy as part of the curriculum typically demonstrate an added benefit and decreased asthma symptoms.12,35–37
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This project was supported by funding from the National Institutes of Health (NR3995), Bethesda, Maryland.