Asthma outpatient education by multiple implementation strategy. Outcome of a programme using a personal notebook

Abstract

More than 10 years after publication, international guidelines remain poorly implemented. To better implement them, we need to develop new strategies adapted to the expectations of patients and health professionals outside hospital settings and to ensure better outpatient follow up in the community. We developed a bilingual education programme including a brochure designed to support an interdisciplinary health care network and measured hospitalisations (H), work absenteeism (WA), emergency visits (EV), asthma medication (AM) and quality of life (QL Juniper) before and 12 months after the intervention. All QL scores improved significantly in comparison with pre-intervention values. Health service use decreased dramatically when comparing the 12 months prior to and after the intervention(H: 35-8%, WA: 39-14%, EV: 88-53%). The final cost/benefit ratio of the programme was 1.96. Interdisciplinary implementation strategy of patient education is cost-effective, improves quality of life for asthmatics, and reduces strain on health services. Such a health care network does not require an expensive infrastructure and is better adapted to the reality and competences of clinical practice.

The Integrated Care of Asthma in Switzerland (INCAS) Study: Changes in Asthma Control and Perception of Health Care through Asthma Education

“…Human subjects participating in a study might change their behaviour simply because they are being investigated [24] . It is also possible that the improvement in disease control after asthma education reflects a placebo effect due to better attention paid by health-care professionals to their patients, rather than an improvement in skills and coping abilities [28] . As the patients in the intervention group showed worse asthma control than the control group at baseline, we cannot exclude the possibility that the reported effect was merely a regression to the mean.…”

Health economics of asthma: assessing the value of asthma interventions

“…Tables 1-4 contain detailed information on each of the economic evaluations organized by their intervention of interest: policy interventions (Table 1), monotherapy controller medications (Table 2), combination controller medications (Table 3), and add-on medications (Table 4). Of the 40 papers that we reviewed, 14 evaluated a policy intervention (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and the other 26 were pharmaceutical comparisons . Of the 14 policy evaluations six considered the economic effects of implementing an education program (22,24,25,28,30,32).…”

“…Of the 40 papers that we reviewed, 14 evaluated a policy intervention (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and the other 26 were pharmaceutical comparisons . Of the 14 policy evaluations six considered the economic effects of implementing an education program (22,24,25,28,30,32). Other studies evaluated management programs (23,26,29,33,35), guidelines (27), and surveillance (31,34).…”

Patient satisfaction with different asthma-training variants

“…Yet there are differences in effectiveness due to several modalities for the delivery of education [27][28][29]. Programmes that are more intensive and involve advice on how to transform information into behaviour (e.g.…”