Gibson P G, Coughlan J, Wilson A J, Hensley M J, Abramson M, Bauman A, Walters E H
Department of Respiratory Medicine, John Hunter Hosptial, Respiratory Medicine, John Hunter Hospital, Locked Bag 1, Hunter Mail Centre, NSW, Australia, 2310.
Cochrane Database Syst Rev. 2000;2002(2):CD001005. doi: 10.1002/14651858.CD001005.
A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education.
The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma.
We searched the Cochrane Airways Group trials register and reference lists of articles.
Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age.
Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for missing information.
Eleven trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but perceived asthma symptoms did improve after limited asthma education (odds ratio 0.40, 95% confidence interval 0.18 to 0.86). In one study, limited asthma education was associated with reduced emergency department visits (weighted mean difference -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18).
REVIEWER'S CONCLUSIONS: Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma. However the use of information in the emergency department may be effective, but this needs to be confirmed.
许多哮喘管理指南的一个关键组成部分是建议对患者进行教育并定期进行医学复查。已经开展了一些对照试验来衡量哮喘教育项目的效果。这些项目提高了患者的知识水平,但其对健康结果的影响尚不明确。从最简单的层面来看,教育仅限于传授有关哮喘、其病因及治疗的信息。本综述聚焦于有限的哮喘教育的效果。
本综述的目的是评估有限(即仅提供信息)的哮喘教育对成年哮喘患者健康结果的影响。
我们检索了Cochrane Airways Group试验注册库及文章的参考文献列表。
仅涉及16岁以上成年人信息传递的个体哮喘教育的随机对照试验。
由两名评审员独立评估试验质量并提取数据。联系研究作者获取缺失信息。
纳入了11项试验。它们的质量参差不齐。有限的哮喘教育并未降低哮喘住院率(加权平均差为每人每年-0.03次住院,95%置信区间为-0.09至0.03)。对看医生次数、肺功能及药物使用没有影响。对哮喘症状的影响不一。正常活动损失天数没有减少,但有限的哮喘教育后,自觉哮喘症状确实有所改善(优势比0.40,95%置信区间0.18至0.86)。在一项研究中,有限的哮喘教育与急诊就诊次数减少有关(加权平均差为每人每年-2.76次就诊,95%置信区间为-4.34至1.18)。
按照目前实施的方式使用有限的哮喘教育似乎并不能改善成年哮喘患者的健康结果。然而,在急诊科提供信息可能有效,但这需要得到证实。