Dhein York, Barczok Michael, Breyer Gerhard Otto, Hellmann Andreas, Oblinger Paul, Weber Michael, Gaus Wilhelm, Bulenda Dietmar
Siemens Betriebskrankenkasse, München.
Z Arztl Fortbild Qualitatssich. 2006;100(6):431-9.
The efficacy of a modular education program for adult asthmatics was evaluated in a controlled, randomized multicenter trial under outpatient conditions for six months. The education was performed with material (patient handout and PowerPoint slides) of the MASA Program (i.e. a modular outpatient education program for adult asthmatics) according to the contents list of the NASA Program (i.e. a national education program for adult asthmatics). In total, 75 patients of seven asthma specialists were included. The complete data of 53 patients were obtained and evaluated. All patients had been diagnosed with asthma in the year before, most of them (54%) with moderately severe asthma. The patients in the intervention group attended a two-hour teaching program for three times; the control group once received a short introduction to the use of a peak-flow meter, an asthma diary and asthma emergency instructions. Compared to the control group, the intervention group patients showed significantly less mild asthma attacks. The mean requirement for inhalation of short-acting beta-agonists was 0.18 times vs. 1.5 times per week for the intervention and the control group, respectively (p = 0.0062). Another primary outcome was the number of unscheduled asthma-related visits to the doctor within six months. There was a trend to lower numbers in the intervention group, but due to the small number of patients the results did not reach significance. The same applies to the patients' estimation of their quality of life, measured by the SF-36 questionnaire. Patients in the intervention group had a significantly better knowledge about their disease (improvement in the number of correctly answered questions: 6.7 times in the intervention and 5.5 times in the control group; p = 0.0062) and showed a better adherence to their regular medication. In conclusion, this trial proves the quality of the MASA education program and its feasibility in the outpatient setting of a chest physician's practice, and it demonstrates the efficacy of outpatient education programs for asthmatics.
在一项为期六个月的门诊条件下的对照随机多中心试验中,对一项针对成年哮喘患者的模块化教育项目的效果进行了评估。根据国家成年哮喘患者教育项目(NASA项目)的内容清单,使用MASA项目(即针对成年哮喘患者的模块化门诊教育项目)的材料(患者手册和PowerPoint幻灯片)进行教育。总共纳入了7名哮喘专家的75名患者。获得并评估了53名患者的完整数据。所有患者在之前一年被诊断为哮喘,其中大多数(54%)为中度至重度哮喘。干预组的患者参加了三次两小时的教学课程;对照组仅一次接受了关于使用峰流速仪、哮喘日记和哮喘急救说明的简短介绍。与对照组相比,干预组患者的轻度哮喘发作明显减少。干预组和对照组短效β受体激动剂的平均吸入需求量分别为每周0.18次和1.5次(p = 0.0062)。另一个主要结果是六个月内计划外的与哮喘相关的就诊次数。干预组有就诊次数减少的趋势,但由于患者数量较少,结果未达到显著水平。通过SF - 36问卷测量的患者生活质量评估情况也是如此。干预组患者对其疾病的了解明显更好(正确回答问题数量的改善:干预组为6.7倍,对照组为5.5倍;p = 0.0062),并且对常规药物的依从性更好。总之,该试验证明了MASA教育项目的质量及其在胸科医生门诊环境中的可行性,并证明了针对哮喘患者的门诊教育项目的有效性。