Gebresilassie Tirhas Gebremedhin, Worku Alemayehu, Ahmed Ahmed Ali, Kabeta Negussie Deyessa
Department of Public Health, College of Health Sciences, Aksum University, P.O.Box: 298, Axum, Tigray, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Pulm Med. 2025 Mar 15;25(1):120. doi: 10.1186/s12890-025-03574-4.
Asthma self-management education empowers patients to manage their condition effectively. However, evidence on its impact in Ethiopia remains limited. This study evaluated the effect of asthma education on asthma control and self-management knowledge among adult asthma patients in Ethiopia.
A quasi-experimental design was employed, with a total of 204 participants, comprising 102 individuals in the intervention group and 102 in the control group at baseline. After accounting for follow-up losses (20.6% in the intervention group and 23.5% in the control group), 81 participants from the intervention group and 78 from the control group were retained six months after the completion of the education (post-intervention). Pre- and post-intervention assessments were conducted using validated questionnaires to measure asthma control levels and self-management knowledge. The intervention group received a structured, small-group asthma education program comprising three sessions over six months. The intervention's effect was analyzed using linear regression models for difference-in-differences and interaction effects, while heterogeneity analysis was performed using a generalized linear model.
10% of the intervention group and 7.8% of the control group reported prior asthma management education, most of which (60%) was over a decade ago. Asthma control levels significantly improved in the intervention group, with a 19.4% increase compared to 0.6% in the control group. The overall increase in the intervention group was 18.8% higher than in the control group (P = 0.03). Similarly, self-management knowledge improved markedly in the intervention group, with a 24.3% increase compared to 0.7% in the control group. The intervention group demonstrated a 23.6% overall improvement relative to the control group (P = 0.000).Participants in the intervention group were six times more likely to achieve well-controlled asthma and 13 times more likely to exhibit good self-management knowledge compared to the comparison group (p < 0.01). The intervention's impact was consistent across subgroups, with no significant variations by socio-demographic and asthma related factors.
Asthma self-management education interventions significantly enhance asthma management knowledge and control levels. This study highlights the need to implement and expand asthma education programs during patient follow-ups to empower patients, to reduce medical costs, unscheduled hospital visits, emergency department visits, and premature mortality.
Registered retrospectively with TRN PACTR202407741896902.
哮喘自我管理教育使患者能够有效管理自身病情。然而，其在埃塞俄比亚的影响证据仍然有限。本研究评估了哮喘教育对埃塞俄比亚成年哮喘患者哮喘控制和自我管理知识的影响。
采用准实验设计，共有204名参与者，基线时干预组102人，对照组102人。在考虑随访失访情况（干预组为20.6%，对照组为23.5%）后，教育结束六个月后（干预后），干预组保留81名参与者，对照组保留78名参与者。干预前后使用经过验证的问卷进行评估，以测量哮喘控制水平和自我管理知识。干预组接受了为期六个月、包含三次课程的结构化小组哮喘教育项目。使用线性回归模型分析干预的差异和交互效应，同时使用广义线性模型进行异质性分析。
干预组10%的参与者和对照组7.8%的参与者报告曾接受过哮喘管理教育，其中大部分（60%）是在十多年前。干预组的哮喘控制水平显著提高，相比之下，对照组仅提高了0.6%，干预组整体提高幅度比对照组高18.8%（P = 0.03）。同样，干预组的自我管理知识也有显著改善，相比之下，对照组仅提高了0.7%，干预组相对于对照组整体提高了23.6%（P = 0.000）。与对照组相比，干预组参与者实现哮喘良好控制的可能性高出六倍，表现出良好自我管理知识的可能性高出13倍（p < 0.01）。干预的影响在各亚组中一致，在社会人口统计学和哮喘相关因素方面无显著差异。
哮喘自我管理教育干预显著提高了哮喘管理知识和控制水平。本研究强调在患者随访期间实施和扩大哮喘教育项目的必要性，以增强患者能力，降低医疗成本、计划外医院就诊、急诊科就诊和过早死亡率。
追溯注册于TRN PACTR202407741896902。
