Table of Contents Author Guidelines Submit a Manuscript
Canadian Respiratory Journal
Volume 7, Issue 5, Pages 395-400
Original Article

Influence of Asthma Education on Asthma Severity, Quality of Life and Environmental Control

Johanne Côté,1 André Cartier,2 Patricia Robichaud,1 Hélène Boutin,1 Jean-Luc Malo,2 Michel Rouleau,3 and Louis-Philippe Boulet1

1Unité de recherche, Le Centre québécois d’excellence en santé respiratoire, Centre de pneumologie de l’hôpital Laval, Sainte-Foy, Canada
2Service de pneumologie de l’hôpital du Sacré-Coeur, Montréal, Canada
3l’hôpital du Saint-Sacrement, Québec City, Québec, Canada

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Several studies have examined the influence of asthma education, focusing mainly on the use of health services.

OBJECTIVES: To assess the influence of an asthma education program (AEP) on airway responsiveness, asthma symptoms, patient quality of life (QOL) and environmental control.

DESIGN: A prospective, randomized, controlled study with parallel groups.

SETTING: Three tertiary care hospitals in Quebec.

POPULATION: One hundred and eighty-eight patients with moderate to severe asthma.

INTERVENTION: After optimization of asthma treatment with inhaled corticosteroids, patients were randomly assigned to receive either an education program based on self-management (group E) or usual care (control group C).

RESULTS: One year after an AEP, there was a significant decrease in the number of days per month without daytime asthma symptoms in group E only (P=0.03). Asthma daily symptom scores decreased significantly in group E in comparison with group C (P=0.006). QOL scores improved markedly in both groups after treatment optimization during the run-in period (P<0.01). After an AEP, the QOL score increased further in group E patients in comparison with group C patients (P=0.04). The concentration of methacholine that induces a 20% fall in forced expiratory volume in 1 s (PC20) improved significantly in both groups (group E 1.2±1.1 to 2.4±0.2, group C 1.5±1.2 to 2.4±1.3, P<0.01). After one year, 26 of 37 patients from group E sensitized to house dust mites (HDM) adopted the specific measures recommended to reduce their exposure to HDM, while none of the 21 subjects from group C did (P<0.001). Among the patients sensitized to cats or dogs, 15% of patients from group E and 23% of patients in group C no longer had a pet at home at the final visit (P>0.5).

CONCLUSIONS: One year after the educational intervention, it was observed that the program had added value over and above that of optimization of medication and regular clinical follow-ups. The education program was highly effective in promoting HDM avoidance measures but minimally effective for removing domestic animals, suggesting that more efficient strategies need to be developed for the latter.