Louis-Philippe Boulet1, Marie-Ève Boulay2, Guylaine Gauthier3, Livia Battisti4, Valérie Chabot3, Marie-France Beauchesne5, Denis Villeneuve3, Patricia Côté3. 1. Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada. Electronic address: lpboulet@med.ulaval.ca. 2. Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada. 3. Réseau québécois de l'asthme et de la MPOC (RQAM), Québec, QC, Canada. 4. Réseau québécois de l'asthme et de la MPOC (RQAM), Québec, QC, Canada; Hôpital St-François d'Assise, Québec, QC, Canada. 5. Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada.
Abstract
BACKGROUND: Although it is a key-recommendation of all recent asthma guidelines, self-management education is still insufficiently offered in primary care settings. AIMS OF THE STUDY: To demonstrate the benefits of an educational program offered at the site of primary care (Family Medicine Clinics- FMC) by trained asthma educators on patient outcomes and healthcare use. METHODS: This was a one-year pre-post intervention study. Patients with a diagnosis of mild to moderate asthma were enrolled from six FMC. After an initial encounter by the educator, an assessment of educational needs and a spirometry were done, followed by 3 follow-up visits at 4-6 weeks, 4-6 months and one year. Expiratory flows, asthma control criteria, knowledge about asthma, adherence to medication and healthcare and medication use were assessed at each visit. RESULTS: Data from 124 asthma patients (41M/83F), aged 55 ± 18 years, were analyzed. After initiating the intervention, there was a progressive increase in asthma knowledge and an improvement in medication adherence. The number of unscheduled visits for respiratory problems went from 137 to 33 (P < 0.0001), the number of antibiotic treatments from 112 to 33 (P = 0.0002) and the number of oral corticosteroids treatments from 26 to 8 (NS). Marked improvements were observed in regard to inhaler technique and provision of a written action plan. CONCLUSION: This study shows that an educational intervention applied at the site of primary care can result in significant improvements in patient asthma outcomes and reduce unscheduled visits and inappropriate use of medications such as antibiotics.
BACKGROUND: Although it is a key-recommendation of all recent asthma guidelines, self-management education is still insufficiently offered in primary care settings. AIMS OF THE STUDY: To demonstrate the benefits of an educational program offered at the site of primary care (Family Medicine Clinics- FMC) by trained asthma educators on patient outcomes and healthcare use. METHODS: This was a one-year pre-post intervention study. Patients with a diagnosis of mild to moderate asthma were enrolled from six FMC. After an initial encounter by the educator, an assessment of educational needs and a spirometry were done, followed by 3 follow-up visits at 4-6 weeks, 4-6 months and one year. Expiratory flows, asthma control criteria, knowledge about asthma, adherence to medication and healthcare and medication use were assessed at each visit. RESULTS: Data from 124 asthmapatients (41M/83F), aged 55 ± 18 years, were analyzed. After initiating the intervention, there was a progressive increase in asthma knowledge and an improvement in medication adherence. The number of unscheduled visits for respiratory problems went from 137 to 33 (P < 0.0001), the number of antibiotic treatments from 112 to 33 (P = 0.0002) and the number of oral corticosteroids treatments from 26 to 8 (NS). Marked improvements were observed in regard to inhaler technique and provision of a written action plan. CONCLUSION: This study shows that an educational intervention applied at the site of primary care can result in significant improvements in patientasthma outcomes and reduce unscheduled visits and inappropriate use of medications such as antibiotics.
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