Randomized trial of a comprehensive asthma education program after an emergency department visit

Brown, Michael D.; Reeves, Mathew J.; Meyerson, Karen; Korzeniewski, Steven J.

doi:10.1016/s1081-1206(10)61368-3

Cited by 49 publications

(35 citation statements)

References 26 publications

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“…A previous study showed that a brief asthma educational intervention resulted in a short-term increase in asthma knowledge and perceived control [14,15]. Another study showed that a self-management education intervention was successfully implemented, but did not provide benefit in terms of quality of life and short-term repeated ED visits outcomes [16]. However, methodological differences, including study design and format of the education intervention prevent direct comparison with our study.…”

Section: Discussionmentioning

confidence: 62%

“…Incidentally, we did our best to deliver our AEI in a relaxed, friendly, and non-judgmental way and, whenever possible, in a good mood. Third, while in other studies non-clinical educators dispensed the AEI [16] pulmonary physicians dispensed ours. In our clinical experience, asthmatic patients feel in security when a specialist is treating them.…”

Section: Insights In Allergy Asthma and Bronchitis Issn 2471-304xmentioning

confidence: 77%

“…Although a bit disappointing, our results do not constitute an exception. Using a more complex design, Brown et al [16] showed that a comprehensive asthma education program delivered after an ED visit was ineffective in adult patients, 40% of subjects not complying with any of the planned educational activities. One reason explaining low patient compliance in implementing AAPs is the unwillingness to use PEF meters.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, education during a visit to the ED has been recommended as an initiative to improve asthma self-management and bring together patients and physicians involved in education, which was one goal of our study [23]. Second, in contrast with programs that are more complex and include several steps, dispensed on various appointments [16] our AEI was delivered in a single session. Furthermore, the session was short, to acknowledge for the stressful situation of patients with acute asthma in the ED.…”

Section: Insights In Allergy Asthma and Bronchitis Issn 2471-304xmentioning

confidence: 99%

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Asthma Education Delivered in the Emergency Department: Does it Encourage Asthma Self-management?

Bohadana¹,

Rokach²,

Izbicki³

2017

Insights Allergy Asthma Bronchitis

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Background: The rates of optimal asthma control and compliance to treatment in Israel are reportedly low. We postulated that adults attending our emergency department (ED) with asthma exacerbation were not using self-management strategies optimally.Objectives: This pilot study aims to: (a) verify the above hypothesis and, if applicable, (b) determine whether an asthma education intervention (AEI) administered in the ED would encourage post-discharge use of a written asthma action plan (AAP).Methods: Thirty-eight adults (>18 yr.) visiting the ED with asthma exacerbation received a 30-min AEI including a written AAP. Prior asthma education was assessed by questionnaire. Follow-up, carried out by phone ≥ 12 months after discharge, assessed AAP use, asthma control (GINA), and exacerbations in the past year.Results: At baseline, participants denied previous education on asthma selfmanagement and AAP use. Of 27 patients available for follow-up, only 5 (18.5%) were using the AAP, assisted by their care-provider. Eighteen subjects (66.7%) presented uncontrolled asthma while, as a whole, the group reported significantly more exacerbation episodes than at enrolment (mean (SD)=5.1 (6.5) vs. 2.7 (3.0) (p=0.0498)). Finally, compared with AAP non-users (n=22) AAP users (n=5) tended to have better asthma control (60% vs. 18%) and fewer episodes of exacerbations (mean (SD)=2.8 (2.2) vs 5.9 (6.9)) but the differences did not reach significance. Conclusion:Delivery to adults of a short AEI in the ED was of limited efficiency in post-discharge boosting of patient/doctor partnership, resulting in sub-optimal AAP use. Feasibility of the AEI in a crowded ED, however, justifies further research on AEI delivery coupled with alternative follow-up strategies targeting patient and doctor perception of AAPs.

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Section: Discussionmentioning

confidence: 62%

Section: Insights In Allergy Asthma and Bronchitis Issn 2471-304xmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Insights In Allergy Asthma and Bronchitis Issn 2471-304xmentioning

confidence: 99%

See 2 more Smart Citations

Asthma Education Delivered in the Emergency Department: Does it Encourage Asthma Self-management?

Bohadana¹,

Rokach²,

Izbicki³

2017

Insights Allergy Asthma Bronchitis

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“…[13,15] A previous study has shown that matrons decrease the need for psychological and social care and improve complicated long-term health conditions among older people. [16] The community matron's knowledge of individual patients' health problems greatly contributes to the perception of continuity of care. In addition, the community matron, because of additional training in prescribing and other medical assessment skills, is seen as giving holistic care, which encompasses aspects of care previously provided by the GP.…”

Section: Introductionmentioning

confidence: 99%

The effects of intervention on the quality of life, sense of coherence and daily activities of frequent attenders

Hirsikangas

Kanste²,

Korpelainen³

et al. 2017

JNEP

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Background and objective: When FAs with chronic disease and various needs are able to keep up their psychological and physical wellbeing, perform daily activities and maintain control of their life, they are able to live an active life and take care of themselves longer, and this has an impact on their quality of life. The role of community matron is to assess an individual's problems and needs for health services and improve the self-care of FAs by providing a needs-based education. The goal of this study is to evaluate the effectiveness of nurse-led intervention on the quality of life, sense of coherence and daily activities of frequent attenders (FAs).Methods: This study is an intervention trial, with a two-year follow-up, including intervention and control groups. The intervention group received nurse-led intervention that included the assessment of FAs care needs, an individualized care plan, support for self-management and service coordination. The FAs in the control group received traditional care, including patient education and support. Self-reported instruments were used to collect data from adult frequent attenders, including the Frenchay Activities Index (FAI), Sense of Coherence (SOC) and 15D, to assess the health-related quality of life (HRQoL). Follow-ups measurements were taken after one year and after two years between 2008 and 2011.Results: The study shows a significant correlation between sense of coherence and quality of life (p < .0005) and quality of life and amount of daily activities performed (p < .0005) in both groups. The intervention group had statistically significantly better sense of coherence at every stage of the study. The activities of daily living statistically significantly weakened in the intervention group (p = .001) from baseline to two years despite intervention, whereas in the control group it remained unchanged. In the control group, a statistically significant correlation was found between sense of coherence and FAs feeling satisfaction with their current life (p = .019). The HRQoL did not differ between the groups during the study. Conclusions:These results indicate a correlation between sense of coherence and quality of life and also between quality of life and amount of daily activities among FAs. Intervention did not improve the quality of life of FAs or their daily functioning. More research is needed to demonstrate the effects of community matron model on FAs care, the role of ehealth needs to be strongly involved.

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Interventions for educating children who are at risk of asthma-related emergency department attendance

Boyd

Lasserson

McKean

et al. 2009

Cochrane Database of Systematic Reviews

143

135

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Randomized trial of a comprehensive asthma education program after an emergency department visit

Cited by 49 publications

References 26 publications

Asthma Education Delivered in the Emergency Department: Does it Encourage Asthma Self-management?

Asthma Education Delivered in the Emergency Department: Does it Encourage Asthma Self-management?

The effects of intervention on the quality of life, sense of coherence and daily activities of frequent attenders

Interventions for educating children who are at risk of asthma-related emergency department attendance

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