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Benefits of an asthma education program provided at primary care sites on asthma outcomes - 30/07/15

Doi : 10.1016/j.rmed.2015.05.004 
Louis-Philippe Boulet a, , Marie-Ève Boulay a, Guylaine Gauthier b, Livia Battisti b, c, Valérie Chabot b, Marie-France Beauchesne d, Denis Villeneuve b, Patricia Côté b
a Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada 
b Réseau québécois de l'asthme et de la MPOC (RQAM), Québec, QC, Canada 
c Hôpital St-François d’Assise, Québec, QC, Canada 
d Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada 

Corresponding author. Institut universitaire de cardiologie et de pneumologie de Québec, 2725, Chemin Sainte-Foy, Québec, QC, G1V 4G5, Canada. Tel.: +1 418 656 4747; fax: +1 418 656 4762.

Summary

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.

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Keywords : Asthma, Education, Asthma control, Asthma treatment, Family practice, Primary care


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Vol 109 - N° 8

P. 991-1000 - août 2015 Retour au numéro
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