Earlier research from the University of California, San Francisco (UCSF) had shown that teaching asthma patients how to manage their disease through self-management educational programs can go a long way to improving their outcomes. Now, new UCSF research shows that adding one personal 30-minute session with a healthcare provider enhances the effectiveness of self-management programs, including improved adherence to medications and better disease control.
In a 24-week randomized controlled trial, the UCSF team asked 84 adults with asthma to monitor their symptoms and keep a daily log of their peak expiratory air flow. Of those 84 study participants, 45 were randomly chosen to also receive a personal 30-minute session with a healthcare provider. During the session, patients were given information about asthma and relevant information on how to reduce their specific exposure to allergens. They were also provided a personal action plan and taught how to get the most from their inhalers, which are not always used to their fullest advantage, says study’s lead author Susan L. Janson, DNSc, RN, NP and a UCSF clinical specialist in pulmonary disease. As Janson notes, often asthma patients don’t breathe deeply enough and in some cases, they even swallow the medication.
The UCSF researchers found that during the 24-week study period, adherence to the inhalers was significantly higher in those patients who had received the personal 30-minute session. Those patients also woke up less during the night and were able to use their rescue inhalers less frequently. They also reported feeling an increased sense of control over their asthma and experienced a decrease in their levels of tryptase, which is released from mast cells in the presence of allergens. “Mortality from asthma is preventable. However, many patients struggle to manage symptoms on their own and often end up visiting emergency departments,” says Janson. “Our study indicates that in a clinical setting, personalized self-management education coupled with self-monitoring may be a cost-effective way to empower patients to better control their disease.”
The study’s findings were published in the April 2009 issue of The Journal of Allergy and Clinical Immunology, just ahead of National Asthma and Allergy Awareness Month, celebrated in May to shed light on the fact that 20 million Americans have asthma and that it remains pooorly controlled among many individuals. And the costs are significant; according to the National Institute of Allergy and Infectious Diseases, in 2007, the direct and indirect costs of asthma on the U.S. economy were $19.7 billion.
News Release: UCSF study shows asthma self-management programs improve drug adherence, disease control www.news.ucsf.educ May 6, 2009
