Self-management education and regular practitioner review for adults with asthma

Training 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 to adjust medication improves health outcomes for adults with asthma.

A Cochrane review comparing self-management education with usual care in asthma included 36 studies with a total of 6 090 subjects. Self-management education reduced hospitalisations (RR 0.64, 95% CI 0.50 to 0.82)), emergency room visits (RR 0.82, 95% CI 0.73 to 0.94), unscheduled visits to the doctor (RR 0.68, 95% CI 0.56 to 0.81), days off work or school (RR 0.79, 95% CI 0.67 to 0.93), nocturnal asthma (RR 0.67, 95% CI 0.0.56 to 0.79); and quality of life (standard mean difference 0.29,CI 0.11 to 0.47). Measures of lung function were little changed. Self-management programmes that involved a written action plan showed a greater reduction in hospitalisation than those that did not (RR 0.58; 95% CI 0.43 to 0.77).

Ədəbiyyat

1. Gibson PG, Powell H, Coughlan J et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev 2003;(1):CD001117.