The Impact of Asthma Management Guideline Dissemination on the Control of Asthma in the Community

Abstract

OBJECTIVE: To measure the impact of asthma management education on the control of asthma in the community.DESIGN: A cross-sectional study comparing three communities.SETTING: Three rural communities in southern Alberta.PATIENTS AND METHODS: A population sample of patients with asthma attending a pharmacy to fill a prescription for asthma medication were selected from three communities. Patients were asked to complete a questionnaire relating to their asthma management and control.INTERVENTION: Three levels of asthma management education were provided in the three communities with populations of 6000 to 10,000. The levels of education ranged from standard continuing medical education programs relating to the national asthma guidelines and a visiting asthma nurse educator to the establishment of an asthma clinic and a multiple-target, intensive education program for health professionals, town leaders, local media, schools and the public. The survey of the population with asthma was conducted approximately one year after the education program had been completed.RESULTS: A total of 327 completed questionnaires were submitted. Analysis showed that there was no significant difference that could be attributed to the intervention in the management of asthma or in the level of asthma control among the patients from the three communities.RESULTS: A total of 327 completed questionnaires were submitted. Analysis showed that there was no significant difference that could be attributed to the intervention in the management of asthma or in the level of asthma control among the patients from the three communities.

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

“…We identified 7 studies 17,18,52,53,56,58,87 involving interactive seminars, structured training, and medical grand rounds. One study reported statistically significant reduction in ED visits (only in a subgroup of low-income participants; -1.23 visits per year, P = .001) and in the overall annual hospitalization rate.…”

“…18,50,53,56,86 Three RCTs used structured training, seminars, and workshops for health care providers to examine the effects on missed school. They reported small but statistically nonsignificant reductions in missed school (0.6-4 days).…”

“…They reported small but statistically nonsignificant reductions in missed school (0.6-4 days). To evaluate the impact on missed work, 2 RCTs 50,86 and 1 pre-post study 56 provided workshops and training in how to perform spirometry, and 1 study compared asthma program development with a nurse educator program to continuing education. All studies reported small, statistically nonsignificant reductions in missed school or work.…”

IV Diretizes Brasileiras para o Manejo da Asma

“…(117) No Brasil, as pesquisas também demonstraram os benefícios desses programas no controle clínico da doença, nos custos diretos e também na qualidade de vida tanto de adultos como de crianças. (118)(119) A educação em asma pode ser direcionada a diferentes públicos: população em geral -informar que a asma é uma doença pulmonar crônica que, se adequadamente tratada, pode ser controlada, permitindo uma vida normal; profissionais ligados à saúde -garantir o diagnóstico correto e a recomendação terapêutica adequada para, conseqüen-temente, diminuir a morbidade e a mortalidade; (121) asmáticos -devem ser educados a reconhecer os sintomas, conhecer os fatores desencadeantes e como evitá-los, a participar ativamente do tratamento, identificando os medicamentos e conhecendo as ações a serem tomadas conforme a evolução da doença; (122) familiares e cuidadores -no sentido de se sentirem confortados com as condutas a serem adotadas em relação à evolução da doença; educação nas escolas, empresas públicas e privadas, e seguradoras de saúde -como lidar com a morbidade e a mortalidade relacionadas à asma. (123) Quanto à forma os programas podem ser informativos ou estruturados.…”

“…(124)(125) O estruturado confere melhores resultados e possui os seguintes requisitos: informação educacional que utiliza as formas escrita, verbal, visual e/ou auditiva; linguagem acessível e adaptada à população-alvo; monitorização dos sintomas e/ou do PFE (usar escores de sintomas, e/ou de uso de broncodilatador e/ou de PFE); consulta médica regular (reavaliação programada do paciente pelo médico e por outros profissionais de saúde); plano de ação individual por escrito que deve ser explicado e entregue ao paciente. (117)(118)(119)(120)(121)(122)(123)(124)(125)(126) O conteúdo básico de um programa de asma é apresentado no Quadro 12. (115) O plano de ação por escrito pode ser colocado em prática pelo próprio paciente (automanejo) e planejado em parceria de acordo com os itens do Quadro 12 e o modelo apresentado no Quadro 13 (Quadro 14).…”