Marabini Alessandra, Brugnami Giuliana, Curradi Ferruccio, Siracusa Andrea
Occupational Medicine and Toxicology, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
J Asthma. 2005 Sep;42(7):577-81. doi: 10.1080/02770900500216101.
Asthma education programs result in clinical improvement. However, most studies involved programs of up to 1 year of follow-up, and their efficacy in improving quality of life (QoL) is still controversial. The aim of this study was to evaluate the effectiveness of a program of patient education in asthmatics over 2 years. Thirty-seven asthmatic patients were randomly allocated to group A (usual treatment) and 32 to group B (usual treatment plus patient education program). The effectiveness of the education program was evaluated by comparing morbidity outcomes at baseline and 12 and 24 months afterwards. At baseline, no intergroup difference emerged in age, sex, smoking, asthma severity, atopy, FEV1, symptom-free days, use of rescue salbutamol, and QoL. One year later, group B subjects had an improvement in the overall QoL (from 5.8 +/- 0.8 to 6.1 +/- 0.7, p < 0.005), and in "Activities" (from 5.3 +/- 0.9 to 5.7 +/- 0.8, p < 0.05) and "Environment" (from 6.4 +/- 1.0 to 6.8 +/- 0.4, p < 0.05) domains. Two years later the "Activities" domain score increased in group B (from 5.3 +/- 0.9 to 5.7 +/- 1.1, p < 0.05). QoL did not vary in group A. The education program was ineffective in all other parameters at both follow-up time-points. In group A, a significant increase in medication expenses and a significant decrease in rescue salbutamol use was found 1 and 2 years after baseline, respectively. In conclusion, this education program improved QoL for 1 year, but the improvement was not sustained in the 2nd year.
哮喘教育项目可带来临床改善。然而，大多数研究涉及的随访时间长达1年，其在改善生活质量（QoL）方面的疗效仍存在争议。本研究的目的是评估一项针对哮喘患者的为期2年的患者教育项目的效果。37名哮喘患者被随机分配至A组（常规治疗），32名被分配至B组（常规治疗加患者教育项目）。通过比较基线时以及之后12个月和24个月的发病情况来评估教育项目的效果。在基线时，两组在年龄、性别、吸烟情况、哮喘严重程度、特应性、第一秒用力呼气容积（FEV1）、无症状天数、急救沙丁胺醇的使用以及生活质量方面均未出现组间差异。1年后，B组受试者的总体生活质量有所改善（从5.8±0.8提高至6.1±0.7，p<0.005），在“活动”（从5.3±0.9提高至5.7±0.8，p<0.05）和“环境”（从6.4±1.0提高至6.8±0.4，p<0.05）领域也有所改善。2年后，B组的“活动”领域得分有所提高（从5.3±0.9提高至5.7±1.1，p<0.05）。A组的生活质量没有变化。在两个随访时间点，教育项目在所有其他参数方面均无效。在A组，分别在基线后1年和2年发现药物费用显著增加以及急救沙丁胺醇的使用显著减少。总之，该教育项目在1年内改善了生活质量，但在第2年这种改善并未持续。
