Impact Of "Three-in-one" Asthma Education And Management Model On Asthma Control And Acknowledge In Asthmatic Patients

Objective: It is estimated that there are nearly 30 million asthmatic patients in China. Most of them did not persist in long-term and standardized treatment because of lacking the knowledge of asthma and not understanding the severity of asthma. So, repeating attack happened in many patients. As a result, the patients'condition became more serious. The purpose of the study was to evaluate the impact of"three-in-one"asthma education and management model on asthma control and acknowledge in asthmatic patients so that we could get sufficient evidence for populari- zation of this model.Methods: 200 outpatients with asthma in our hospital were selected during Mar, 2009 to Dec, 2010. The educated group (78 cases) took part in"three-in-one"asthma education and management model. They participated in one time primary education and at least two times strengthened education. The control group (122 cases) did not take part in the"three-in-one"asthma education and management model. The two groups were in accord with the diagnosis standard of Chinese guide for asthma in 2008. There were 30 male cases and 48 female cases in educated group with the average age of 55.22±14.86 years and 46 male cases and 76 female cases in control group with the average age of 44.75±17.54 years. The two groups had no any communication disorder. The contents of questionnaire were as follows: 1. The basic data included name, sex, age, education degree and course of the patients. 2. The current situation of asthma control included the level of controlled asthma according to the GINA criteria in 2009 and the level of well-controlled asthma and complete controlled according to the asthma control test (ACT values≥20 points). 3. The acknowledge of asthma included that asthmatic patients thought asthma a chronic airway inflammatory disease and inhalation to be the best way of asthma treatment at present and asthma to be capable of long-term being controlled. 4. The management of asthma included the following: (1) Whether asthmatic patients took lung function in the first time of diagnosis and in the past one year of treatment. (2) Whether the patients got a long-term treatment from a specialized physician. (3) Whether the patients regularly used ICS or combination preparation with ICS everyday. The graduate student and doctors interviewed 200 cases with asthma in the form of face-to-face. The data was analyzed by SPSS 17.0 statistical analysis software, P<0.05 was considered statistically significant.Results: 1. In the current situation of asthma control, according to the GINA criteria in 2009, the rate of controlled asthma for the two groups was 51.3% and 20.5%, respectively (χ2=20.56, P<0.05). The result in the educated group was better than that in the control group. Compared with the overseas studies, the result in the educated group was better than that of AIR study in 2000 (34.3%) and also better than those of American and other countries in Europe. Compared with the domestic studies, the result in the educated group was better than that of the six different urban districts of Beijing in 2006 (25.2%). While according to the asthma control test, the rate of well-controlled and complete controlled for the two groups was 61.5% and 42.6%, respectively (χ2=6.81, P<0.05). The result in the educated group was better than that in the control group. The result in the educated group was better than that of the six different urban districts of Beijing in 2006 (46.3%) and also better than the study in the People's Hospital of Peking University in 2005 (60.7%).2. In the acknowledge of asthma, (1) The rate of thought of asthma as a chronic airway inflammatory disease for the two groups was 76.9% and 55.7%, respectively (χ2=9.269, P<0.05). The result in the educated group was better than that in the control group and also better than that of the six different urban districts of Beijing in 2006 (69.6%). (2) The rate of considering inhalation the best way of asthma treatment for the two groups was 82.1% and 55.7%, respectively (χ2=14.68, P<0.05). The result in the educated group was better than that in the control group. (3) The rate of considering asthma capable of being long-term controlled for the two groups was 85.9% and 61.5%, respectively (χ2=13.78, P<0.05). The result in the educated group was better than that in the control group and also better than that of the six different urban districts of Beijing in 2006 (78%).3. In the management of asthma, (1) The rate of taking lung function in the first time of diagnosis for the two groups was 89.7% and 86.9%, respectively (χ2=0.37, P>0.05). The differences between the two groups had no statistically significance, but the result in the educated group was better than that of the six different urban districts of Beijing in 2006 (81.9%). (2) The rate of taking lung function in the past one year of treatment for the two groups was 79.5% and 57.4%, respectively (χ2=10.365, P<0.05). The result in the educated group was better than that in the control group and also better than that of the six different urban districts of Beijing in 2006 (46.1%). (3) The rate of getting a long-term treatment from a specialized physician, for the two groups was 75.6% and 43.4%, respectively (χ2=20.02, P<0.05). The result in the educated group was better than that in the control group. (4) The rate of regularly using ICS or combination preparation with ICS everyday for the two groups was 74.4% and 42.6%, respectively (χ2=19.36, P<0.05). The result in the educated group was better than that in the control group.Conclusion:"Three-in-one"asthma education and management model can increase the patients'acknowledge of asthma and treatment compliance. Meanwhile remarkably improve asthma control.