This paper presents a PICO-formatted evidence review exploring whether patient and family education in self-care management improves health and functional status in adult asthmatics. Using a PubMed database search, two peer-reviewed studies are identified and summarized. The first evaluates a randomized controlled asthma education program measuring morbidity and treatment compliance across three groups. The second assesses a hospital-based education program for low-socioeconomic-status patients in Hong Kong, measuring lung function, inhaler technique, asthma knowledge, and healthcare utilization. Both studies support the value of self-care education, particularly for high-risk and underserved populations, though they differ significantly in scope, methodology, and demographic focus.
Does education of the patient and family in self-care management result in improved health and functional status in adult asthmatics?
To conduct the search, the PubMed database was used, and the crucial search terms identified were "adult asthmatic" — to specify the population group and the condition of interest — and "self-care," as fostering self-care was the primary concern of the question, rather than the efficacy of specific treatments or medications. Without limits applied, 515 documents were returned. Reviewing the first results revealed several helpful and relevant articles, particularly among the related links listed in the right-hand panel.
The first study of note was: "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 during the year before and the year after the intervention. Before entering the study, participants' asthma treatment was optimized by respirologists.
All participants were assigned to one of three groups: Group C (the control group, which did not participate in the educational program), Group P (which participated in the educational program using a treatment plan based on peak-flow monitoring), and Group S (which received education with a treatment plan based on monitoring of asthma symptoms). A total of 188 volunteers with moderate to severe asthma were enrolled, of whom 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 and added to patients' knowledge about asthma. However, education did not appear to confer additional benefit with regard to morbidity. The study's authors noted that further research was warranted, as educational intervention may be more beneficial in patients who begin with less optimal care and have high-risk factors. The relatively short duration of the study was also acknowledged as a limitation.
The second study of relevance was: "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 notable not only for its international scope, but also because it offers insight into healthcare in another cultural context, examining a socioeconomic group where health education is often lacking and which is frequently disproportionately affected by asthma due to environmental conditions.
In this study, patients attending an asthma clinic received instruction during a two-hour educational session covering asthma, its potential triggers, appropriate use of medications, proper inhaler techniques, and self-management of their disease. The findings regarding the benefits of education were more striking than in the first study. Of the 230 patients recruited, 83% completed the study. The group demonstrated significant improvements in lung function. There were also significant improvements in inhaler technique, asthma knowledge, and patients' self-rating of the severity of their symptoms.
Additionally, the study recorded 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. The study concluded that patient education in asthma self-management was beneficial, particularly for underserved populations.
"Comparison and justification of both selected studies"
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