Abstract
BACKGROUND: This observational study compared the effectiveness of a standardized adult asthma education program administered in a variety of sites and practice settings on health care utilization, absenteeism, amount of leisure time missed and quality of life (using the Medical Outcomes Study 36-Item Short Form 1.0 [SF-36]).METHODS: Seven asthma centres participated in an uncontrolled, multicentre, prospective, observational study using a pre-post design. Variables included hospital- and community-based centres, an academic hospital setting and the presence or absence of physician attendance. Trained asthma educators administered a guided self- management education program, and standardized questionnaires were used for patient assessment at baseline and six months after education.RESULTS: Of the 517 patients enrolled at baseline, 396 were eligible for the six-month follow-up. Follow-up data were available for 252 patients. SF-36 data were collected for 241 patients at six sites, with follow-up data available for 103 of 155 eligible patients. Asthma education was associated with substantial improvements in scheduled and unscheduled physician visits, unscheduled specialist visits, emergency department visits, hospital admissions, hospitalized days, missed work or school days and missed days of leisure time. There were also statistically significant improvements in all but one SF-36 domain. These improvements were comparable across all geographical sites and physical settings.CONCLUSIONS: Standardized asthma education appears to be effective when administered in a variety of practice settings, and may be associated with significant improvements in patient outcomes. The significant decline in health care utilization implies that substantial health care savings may occur as a result of the implementation of standardized asthma education programs.