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Evaluation of the efficacy of a hospital‐based asthma education programme in patients of low socioeconomic status in Hong Kong
Author(s) -
D. Choy,
Man Tong,
Fanny W. Ko,
S. T. Li,
A. Ho,
Joey Wing Yan Chan,
Roland Leung,
Chun Lai
Publication year - 1999
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1046/j.1365-2222.1999.00481.x
Subject(s) - medicine , asthma , inhaler , attendance , emergency department , socioeconomic status , outpatient clinic , patient education , physical therapy , self management , population , family medicine , emergency medicine , nursing , environmental health , computer science , economics , economic growth , machine learning
Background Good asthma control requires optimal medical treatment in conjunction with appropriate self‐management. In the West, the effectiveness of patient education on improving self‐management has been well documented. However, data amongst Asian populations are lacking. We performed a pilot study to evaluate the efficacy of a hospital based education programme aimed at improving self‐management skills and reducing morbidity in a Chinese population with low socioeconomic status and education level. Methods Our asthma education programme was a low‐cost programme conducted in essence by specialist respiratory nurses. Patients attending our asthma clinic were instructed during a two‐hour educational session on the pathophysiology of asthma, its potential triggers, the appropriate use of medications including proper inhaler techniques, and the self‐management of their disease. These instructions were reinforced by video sessions at subsequent outpatient clinic attendance when patients' inhaler and peak flow techniques were checked by the same nurses and their self‐management plan re‐examined by the attending physicians. Asthma knowledge, inhaler technique, FEV 1 and peak expiratory flow (PEF), and patients' self‐rating of their asthma were determined at baseline, 6 months and 1 year after the intervention. Morbidity was assessed by the numbers of hospitalizations, unscheduled visits to family physicians and accident and emergency department attendance, courses of oral steroid used and days off work or school at baseline and 1 year. Results Two hundred and thirty patients were recruited for the study, 83% completing the entire assessment period. The group demonstrated significant improvements in lung function: the mean FEV 1 ± SD increased from 63.6 ± 20.6% of predicted values at baseline to 68.5 ± 22.3% at 6 months and 68.6 ± 22.8% at 1 year ( P < 0.05), and the mean PEF ± sd increased from 64.6 ± 23.0% of predicted values at baseline to 75.4 ± 27.0% at 6 months and 76.8 ± 24.5% at 1 year ( P < 0.001). There were also significant improvements in inhaler technique ( P < 0.01), asthma knowledge ( P < 0.001), patients' self‐rating of their asthma ( P < 0.05), and reductions in the numbers of hospitalizations ( P < 0.01), visits to family physicians ( P < 0.001) and accident and emergency department attendance ( P < 0.001) during the study period. Patients with moderate to severe asthma as defined by an FEV 1 of < 80% of predicted values were most likely to benefit from the programme. Conclusions We conclude that patient education is likely to be an essential component in the holistic approach to the management of asthma even amongst Asian populations of low socioeconomic status and education level. Further studies using randomised controlled trials are necessary to consolidate our findings.