An education programme for asthma and COPD patients conducted by a general practice assistant; a randomised controlled trial

Abstract

Aim:To improve disease control and thereby health related quality of life (HRQoL) in patients with asthma or chronic obstructive pulmonary disease (COPD) in general practice, we developed and evaluated an education program conducted by a practice assistant. Methods: 272 Asthma and COPD patients were stratified by age and randomly assigned to the intervention (n=139) or control group (n=137). The intervention program consisted of training regarding inhalation technique, and patient centred information about the disease, medication, hyperreactivity, and coping with their disease. The control group received usual care. Measurements took place before randomisation and after one and two years. Outcome measures included HRQoL and disease symptoms. Furthermore, process measures included compliance, inhalation technique, coping and self-efficacy.Results:209 patients (77 %) completed at least one year follow-up. No differences regarding HRQoL and disease symptoms were observed between the intervention and the usual-care group. In addition, no differences were observed in compliance, coping, and self-efficacy. However, after one and two years the inhalation technique improved significantly (p<0.05) in the intervention group (adequate technique in respectively 62% and 71%) compared to the control group (respectively 42% and 59%).Conclusion:Our results show that an education by a practice assistant may result in an important improvement of inhalation technique in patients with asthma or COPD. However, no effects were found on HRQoL or disease symptoms.