Asthma Research on Medline Using

Asthma

research on Medline using PICO

Research on Medline using PICO format: Adult asthmatics

This paper will examine how a search conducted on Medline can answer a question phased in the 'PICO' formula: P (patient) I (intervention) C (comparison) O. Outcome. The research question is as follows: Does education of the patient and the family in self-care management result in improved health and functional status in adult asthmatics? P=Adult Asthmatics, I=Education of the patient and family in self-care management, C=education vs. non-education, O= Improved health and functional status.

Search items: "adult asthmatics education"

I selected these terms because they focused on adult asthmatics. The nature of asthma in adults is different, in terms of the patient's responsibility and autonomy over his or her illness, than asthma suffered by a child, and the focus of the research was to be on adult education and self-care. No limits were applied. 235 results were retrieved. Next, I tried a Boolean search: "adult asthmatics ONLY education," so that patient education for adult asthmatics would be the focus of the search. This retrieved 72 items, but was still headed by the same research study.

Two relevant Studies

The first study by Adeyeye and Onadeko (2008) from the Journal of West African Medicine, entitled "Understanding medication and use of drug delivery device by asthmatic in Lagos" was an examination of asthma education programs in Lagos, Nigeria amongst a traditionally, medically-underserved population. The study found there was an acute lack of knowledge about proper asthma treatment in the population. This study makes a useful and dramatic point of comparison, with the developed world, as it is a study of the degree of ignorance frequently exhibited in areas with little access to medical care. Fifty-two of the study subjects, or 49.1% been hospitalized for their conditions and 45.3% had gone to the emergency room in the week preceding the interview with the researchers. 52.8% did not know how to use their inhalers properly, and almost all patients did not take their prescribed asthma medication. This study shows a strong correlation between ignorance and a lack of control of asthma symptoms.

The second study by Ulrik et al. (2009), "Disease variability in asthma: how do the patients respond? -- and why?" from the Journal of Asthma was to explore patterns of self-management in adult asthmatics, and found, interestingly enough, that education was not necessarily a panacea: despite instruction, two-thirds of the study subjects would increase their use of inhaled corticosteroids (ICS) when their symptoms worsened, but only 23% took their controller medication in the case of deterioration, although 59% were instructed to do by their physicians. Despite doctors' efforts to educate patients on the importance of minimizing inhaler use and using medication to prevent attacks, the study concluded that the patients' preferred strategy for management of disease variability did not seem to be driven by their knowledge of the disease.