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1 Dept of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, 2 Depts of Pulmonary Medicine and 3 Epidemiology, Dekkerswald, University of Nijmegen and 4 Dept of Psychology, University of Twente, Enschede, the Netherlands
CORRESPONDENCE: J.J. Klein, Medisch Spectrum Twente, Afdeling Longziekten, Postbus 50000, 7500 KA, Enschede, the Netherlands. Fax: 31 0 534872638
Keywords: asthma, patient education, self-management, self-treatment
Received: February 3, 2000
Accepted September 19, 2000
This study
was funded by the Netherlands Asthma Foundation (Grant 94-52),
GlaxoWellcome, the "Stichting Astmabestrijding", and Amicon Health
Care Insurance Fund.
This study assessed the long-term efficacy of adding self-treatment
guidelines to a self-management programme for adults with asthma.
In this prospective randomized controlled trial, 245 patients with stable,
moderate to severe asthma were included. They were randomized into a self-treatment
group (group S) and a control group (group C). Both groups
received self-management education. Additionally, group S received self-treatment
guidelines based on peak expiratory flow (PEF) and symptoms. Outcome
parameters included: asthma symptoms, quality of life, pulmonary function,
and exacerbation rate. The 2-yr study was completed by 174 patients.
Both groups showed an improvement in the quality of life of 7%.
PEF variability decreased by 32% and 29%, and the number of
outpatient visits by 25% and 18% in groups S and C, respectively.
No significant differences in these parameters were found between the two
groups. After 1 yr, patients in both groups perceived better control
of asthma and had more self-confidence regarding their asthma. The latter
improvements were significantly greater in group S as compared to group C.
There were no other differences in outcome parameters between the groups.
Individual self-treatment guidelines for exacerbations on top of a
general self-management programme does not seem to be of additional benefit
in terms of improvements in the clinical outcome of asthma. However, patients
in the self-treatment group had better scores in subjective outcome measures
such as perceived control of asthma and self-confidence than patients
in the control group.
This article has been cited by other articles:
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  E. Monninkhof, P. van der Valk, J. van der Palen, C. van Herwaarden, and G. Zielhuis Effects of a comprehensive self-management programme in patients with chronic obstructive pulmonary disease Eur. Respir. J., November 1, 2003; 22(5): 815 - 820. [Abstract] [Full Text] [PDF]
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 E Monninkhof, P van der Valk, J van der Palen, C van Herwaarden, M R Partridge, and G Zielhuis Self-management education for patients with chronic obstructive pulmonary disease: a systematic review Thorax, May 1, 2003; 58(5): 394 - 398. [Abstract] [Full Text] [PDF]
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 T. R. Schermer, B. P. Thoonen, G. van den Boom, R. P. Akkermans, R. P. Grol, H. T. Folgering, C. van Weel, and C. P. van Schayck Randomized Controlled Economic Evaluation of Asthma Self-Management in Primary Health Care Am. J. Respir. Crit. Care Med., October 15, 2002; 166(8): 1062 - 1072. [Abstract] [Full Text] [PDF]
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