Question 3. Which educational strategies and methods have been found to be effective in influencing clinical outcomes?

From Chapter 7 of the Philippine Consensus Report on Asthma 2004 by the Philippine College of Chest Physicians.
This guideline starts below.

Which educational strategies and methods have been found to be effective in influencing clinical outcomes?

Answer

Educational strategies that focus on individuals or small groups employing multiple interactive educational methods, and incorporating self-management skills transfer, self-monitoring modalities, and regular practitioner review have been found to be effective. However, strategies that are limited to the transfer of information about asthma, its causes and its treatment have not been shown to improve health outcomes.

Summary of Evidence

A recent review showed that published asthma educational programs for adults vary widely in terms of general and educational objectives, teaching techniques, tools, content, assigned trainers, duration of intervention and number of sessions. Thus, this precludes replication and reduces the possibility of identifying the most effective components. Nevertheless, a systematic review of 11 randomized controlled trials of variable quality showed that limited asthma education (information only) among patients aged 16 years and above did not reduce hospitalization for asthma and had no effect on doctor visits, lung function and medication use. The effects of these educational programs on asthma symptoms were variable. There was no reduction in days lost from normal activity. Moreover, programs relying primarily on providing books or videotapes to asthma patients were successful only in improving knowledge.

Very few studies have addressed the optimal method for educational intervention. As described in the previous section, programs that focus on asthma self-management skills and are coupled with regular practitioner review, rather than usual care, improve morbidity indices. Sub-analyses of these clinical trials showed that those that involved individualized written asthma action plans showed greater reduction in hospitalization than those that did not.

Asthma education should ideally begin in the physician's office and this can be effective only in the presence of appropriate asthma therapy. With regards to the comparison between educational programs focused on individuals versus those using small groups, there appeared to be few differences in outcomes, although small-group teaching resulted in a slight decrease in frequency of exacerbations, possibly because of the influence of peer support.

As to the issue of PEF self-monitoring, this practice may be useful in some patients, particularly those who are poor perceivers of airflow obstruction. Patient self-monitoring may be effective using either measurement of PEF or monitoring of symptoms.Recommendation

Patient education is a key and essential component of successful asthma management. Education is a necessary tool not only as means to acquire knowledge about the condition but also to help patients gain the motivation, skills and confidence to control their asthma.

Well-designed asthma education programs have been shown to be effective in reducing asthma morbidity indices over a wide range of patient population.