Study shows asthma self-management programs improve drug adherence, disease control

May 06, 2009

Asthma patients who spend as little as 30 minutes with a health care professional to develop a personalized self-management plan show improved adherence to medications and better disease control, according to a new study by a team of researchers at the University of California, San Francisco.

Study findings are published in the April 2009 issue of "The ."

May is National and Allergy Awareness Month. An estimated 20 million people in the United States have asthma and despite the availability of treatments, the disease remains poorly controlled among many individuals, according to the Asthma and Allergy Foundation of America. In 2007, the direct and indirect costs of asthma to the United States economy were $19.7 billion, reports the National Institute of Allergy and Infectious Diseases.

"Mortality from asthma is preventable. However, many patients struggle to manage symptoms on their own and often end up visiting emergency departments. Our study indicates that in a clinical setting, personalized self-management education coupled with self-monitoring may be a cost-effective way to empower patients to better control their disease," said the study's lead author Susan L. Janson, DNSc, RN, NP, a UCSF clinical specialist in pulmonary disease.

Earlier UCSF research has shown that teaching asthma patients how to self-manage their disease can improve health outcomes and that tailored education is more effective than standardized programs because patients find it more personally relevant. It has been unclear, however, which components of self-management education lead to better control of the disease, according to Janson, who also is a professor in the UCSF School of Nursing and adjunct professor in the UCSF School of Medicine.

The UCSF team conducted a 24-week randomized, controlled trial to determine if individualized instruction in asthma self-management adds significantly to the effects of self-monitoring alone on patients' adherence to inhaled corticosteroids (ICSs), medications that can help reduce inflammation in the airway and prevent asthma attacks.

In the study, 84 adults with asthma self-monitored their symptoms and kept a daily log of their peak expiratory air flow. Of that group, 45 patients were randomly selected to also receive a personal 30-minute session that included asthma information, personally relevant allergen exposure reduction, a personal action plan, and instruction in the correct use of their inhalers.

According to Janson, many people with asthma don't receive the full advantage of inhalers because they don't breathe deeply enough or sometimes swallow the medication. In addition, different models of inhalers require different techniques to operate effectively.

Members of the intervention group also were skin tested for allergies, and strategies were then developed to reduce allergens in their surroundings.

"Environmental exposure is an important factor to evaluate when asthma is out of control," said Janson. "People understandably are reluctant to get rid of a pet or spend money on dust mite covers for their beds without knowing if animals or dust mites are aggravating the disease. A personalized approach helps develop skills specific to their own allergies."

During the study period, adherence to ICSs was consistently higher in the intervention group compared with the control group. In addition, participants in the intervention group experienced fewer nighttime awakenings, a marker of asthma control. Intervention participants also used rescue inhalers less frequently, experienced an increased sense of control over their asthma, and had a significant decrease in their levels of tryptase, which is released from cells in the presence of allergens.

Source: University of California - San Francisco

Explore further: Researchers develop a new drug to combat the measles

add to favorites email to friend print save as pdf

Related Stories

Pharmacists as educators can improve asthma outcomes

Jun 24, 2008

New research has shown that up to 90 per cent of people on asthma medications are using their inhalers incorrectly leading to poor asthma control, increased hospital visits and increased cost of treatment.

Survey shows asthma not controlled in majority of patients

May 30, 2007

WINSTON-SALEM, N.C. – A survey of 1,812 patients with moderate-to-severe asthma revealed that the disease was not controlled in 55 percent, despite the fact that most had health insurance and visited their health care providers ...

Increased allergen levels in homes linked to asthma

Mar 01, 2008

Results from a new national survey demonstrate that elevated allergen levels in the home are associated with asthma symptoms in allergic individuals. The study suggests that asthmatics that have allergies may alleviate symptoms ...

Antibiotic treatment targets difficult asthma

Dec 17, 2007

Hunter researchers have shown that a commonly available antibiotic can improve the quality of life of patients with difficult asthma, and may also generate significant health care savings.

Recommended for you

New MRSA superbug emerges in Brazil

7 minutes ago

An international research team led by Cesar A. Arias, M.D., Ph.D., at The University of Texas Health Science Center at Houston (UTHealth) has identified a new superbug that caused a bloodstream infection ...

Ebola virus in Africa outbreak is a new strain

19 hours ago

The Ebola virus that has killed scores of people in Guinea this year is a new strain—evidence that the disease did not spread there from outbreaks in some other African nations, scientists report.

User comments : 0

More news stories

Classifying cognitive styles across disciplines

Educators have tried to boost learning by focusing on differences in learning styles. Management consultants tout the impact that different decision-making styles have on productivity. Various fields have ...

Internet use may cut retirees' depression

Spending time online has the potential to ward off depression among retirees, particularly among those who live alone, according to research published online in The Journals of Gerontology, Series B: Psychological Sciences an ...

Tiny power plants hold promise for nuclear energy

Small underground nuclear power plants that could be cheaper to build than their behemoth counterparts may herald the future for an energy industry under intense scrutiny since the Fukushima disaster, the ...