Systems Healthcare PICO Formatted Question

¶ … Systems Healthcare

PICO formatted question

Does education of the patient and the family in self-care management result in improved health and functional status in adult asthmatics?

Conducting the search entered the PubMed data base and determined that the crucial search terms would be the words 'adult asthmatic' (in short, that it was critical to identify the population group and the condition that was of interest) and 'self-care,' as the question of fostering self-care was the primary concern of the question, as opposed to the efficacy of certain treatments or medications. 515 documents without limits were recorded. I clicked on the first link, and found some very helpful and relevant articles, not in this first citation, but in the long, right-hand list of related links.

Summarize two relevant studies

Immediately, my eye was drawn to the study: "Influence on asthma morbidity of asthma education programs based on self-management plans following treatment optimization." The objective of this study was to evaluate the effectiveness of an asthma education program on morbidity, knowledge, and compliance with inhaled corticosteroid treatment using a prospective, randomized, controlled, population. Subjects were studied one year before and after the study. Before entering the study, their asthma treatment was optimized by of respirologists. All were assigned to three groups: Group C (the control group that was did not participate in the educational program), Group P (which participated in the educational program for a treatment plan based on peak-flow monitoring), and Group S (education with treatment plan based on monitoring of asthma symptoms). 188 volunteers with moderate to severe asthma were enrolled in the study. 149 completed the study. Asthma morbidity decreased in all three groups. In the two experimental groups, structured asthma education significantly improved short-term compliance with both treatment plans as well as added to the patient's knowledge about asthma, although education did not seem to add an extra benefit with regard to morbidity. Further research was needed, however, according to the study's authors, given that educational intervention may be more beneficial in patients with less optimal care and education to begin with and high-risk factors. Also the study was of relatively short duration.

The second study of relevance and interest was an "Evaluation of the efficacy of a hospital-based asthma education program in patients of low socioeconomic status in Hong Kong" This study of adult asthmatics was of interest not simply because of its international scope, but also because it offers a snapshot of medicine in another cultural context, of a relevant socioeconomic group where health education is often lacking, and which is often disproportionately affected by asthma because of environmental conditions.

In the study, patients attending an asthma clinic were instructed during a two-hour educational session on asthma, its potential triggers, the appropriate use of medications, proper inhaler techniques, and the self-management of their disease. This study was more dramatic in its findings regarding the improving benefits of education. 230 patients were recruited for the study, and 83% completed the study. The group demonstrated significant improvements in lung function. There were also significant improvements in inhaler technique, asthma knowledge and patient's self-rating of the severity of their asthma symptoms. There were also reductions in the numbers of hospitalizations, visits to family physicians and accident and emergency room attendance during the study period. Patients with moderate to severe asthma were most likely to benefit from the program, thus the study concluded that patient education was beneficial.