Barthwal M S, Katoch C D S, Marwah V
Department of Respiratory Medicine, Military Hospital, Namkum, Ranchi.
J Assoc Physicians India. 2009 Aug;57:574-6, 579.
Optimal asthma education (comprising of information, self monitoring, regular medical reviews and a written action plan) significantly improves asthma management. The study was undertaken to assess the impact of optimal asthma education programme on asthma morbidity, inhalation technique and asthma knowledge.
In non-randomized prospective trial asthma morbidity, (comprising of control of symptoms, unscheduled OPD visits and limitation of physical activities), inhalation technique and asthma knowledge were assessed before and one year after implementation of optimal asthma education programme.
One hundred and seventy two patients of persistent bronchial asthma aged 12 years or more, taking daily anti-inflammatory drugs and having not attended any type of asthma education programme before were included in the present study.
There was significant improvement in asthma morbidity with increase in the number of patients with intermittent and mild persistent asthma and significant decrease in patients with moderate and severe persistent asthma. Before optimal AEP, 30 (17.4%) patients had visited hospital thrice or more due to asthma sickness, after optimal AEP only 5 (8.6%) patients made unscheduled visits only once to hospital (p<0.05). Limitation of physical activities was present in 80 (46.51%) patients before AEP which was significantly reduced to 15 (8.7%) patients after optimal AEP (p<0.05%). Before AEP, inhalation technique was incorrect in 140 (81.3%) patients and after AEP none of the patients had incorrect technique (p<0.001). Only 24 (13.9%) patients had satisfactory knowledge of asthma before AEP and after AEP the number increased significantly to 120 (69.7%) (p<0.001).
Optimal asthma education is an integral part of asthma management which decreases asthma related morbidity, improves inhalation technique and asthma knowledge. Since our follow up was for one year and impact of asthma education programme is likely to decrease in absence of regular follow up, it is important to keep reminding patients about asthma education programme at each follow up visit.
最佳哮喘教育（包括信息、自我监测、定期医学评估和书面行动计划）能显著改善哮喘管理。本研究旨在评估最佳哮喘教育计划对哮喘发病率、吸入技术和哮喘知识的影响。
在非随机前瞻性试验中，在实施最佳哮喘教育计划前及实施一年后，对哮喘发病率（包括症状控制、非计划门诊就诊和身体活动受限情况）、吸入技术和哮喘知识进行评估。
本研究纳入了172例12岁及以上的持续性支气管哮喘患者，这些患者每日服用抗炎药物且此前未参加过任何类型的哮喘教育计划。
哮喘发病率有显著改善，间歇性和轻度持续性哮喘患者数量增加，中度和重度持续性哮喘患者数量显著减少。在最佳哮喘教育计划实施前，30例（17.4%）患者因哮喘疾病三次或更多次就诊，最佳哮喘教育计划实施后，只有5例（8.6%）患者仅一次非计划就诊（p<0.05）。在哮喘教育计划实施前，80例（46.51%）患者存在身体活动受限情况，最佳哮喘教育计划实施后显著减少至15例（8.7%）患者（p<0.05%）。在哮喘教育计划实施前，140例（81.3%）患者吸入技术不正确，哮喘教育计划实施后，无患者吸入技术不正确（p<0.001）。在哮喘教育计划实施前，只有24例（13.9%）患者对哮喘有满意的了解，哮喘教育计划实施后，这一数字显著增加至120例（69.7%）（p<0.001）。
最佳哮喘教育是哮喘管理的一个组成部分，可降低与哮喘相关的发病率，改善吸入技术和哮喘知识。由于我们的随访为期一年，且在没有定期随访的情况下哮喘教育计划的影响可能会降低，因此在每次随访时不断提醒患者哮喘教育计划很重要。
