Benefits of individualized asthma care

 Spending just 30 minutes with the patient improved adherence to asthma treatment and control over the disease, according to researchers at the University of California, San Francisco.

First, the details.

• 84 adults with moderate-to-severe asthma participated in a 24-week study.
• After stabilization on inhaled corticosteroids, they were randomly assigned to a treatment group.
• Usual care
• Individualized 30-minute self-management education, including self-monitoring of symptoms and peak flow
• The consultation included providing asthma information, making assessments, and correcting inhaler technique.
• Environmental control strategies for allergens and irritants were used.
• Training was personalized based on lung function, allergen skin test reactivity, and inhaler technique and reinforced at 2-week intervals.
• All participants self-monitored their disease and treatment.

And, the results.

• Individualized care lead to significantly higher adherence to drug treatment throughout the study.
• There were also significant improvements in perceived control of asthma, decreased nighttime awakenings, and decreased inhaled β-agonist use.

The bottom line?
The authors concluded, “Individualized asthma self-management education attenuates the usual decrease in medication adherence and improves clinical markers of asthma control.”

Many factors conspire to prevent healthcare professionals from undertaking comprehensive counseling and patient education. These include “lack of time, lack of parent’s [or patient’s] interest, and lack of placebo devices useful for demonstration of inhalation technique.” And, did I mention lack of payment for the service.

However, when provided opportunities to improve their skills, healthcare professionals can make a positive impact. In a study of children, there was improvement in the number of days affected by asthma symptoms, and asthma health care use. “Patients with more frequent asthma symptoms and higher health care utilization at baseline were more likely to benefit from their physician’s participation in the program.”

5/8/09 13:08 JR