Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2000;2002(2):CD001117.
doi: 10.1002/14651858.CD001117.

Self-management education and regular practitioner review for adults with asthma

P G Gibson  1 , J Coughlan, A J Wilson, M Abramson, A Bauman, M J Hensley, E H Walters
Affiliations

Self-management education and regular practitioner review for adults with asthma

P G Gibson et al. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Background: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. This review was conducted to examine the strength of evidence supporting Step 6 of the Australian Asthma Management Plan: "Educate and Review Regularly"; to test whether health outcomes are influenced by education and self-management programmes.

Objectives: The objective of this review was to assess the effects of asthma self-management programmes, when coupled with regular health practitioner review, on health outcomes in adults with asthma.

Search strategy: We searched the Cochrane Airways Group trials register and reference lists of articles.

Selection criteria: Randomised trials of self-management education in adults over 16 years of age with asthma.

Data collection and analysis: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation.

Main results: Twenty-five trials were included. Self-management education was compared with usual care in 22 studies. Self-management education reduced hospitalisations (odds ratio 0.57, 95% confidence interval 0.38 to 0.88); emergency room visits (odds ratio 0.71, 95% confidence interval (0.57 to 0.90); unscheduled visits to the doctor (odds ratio 0.57, 95% confidence interval 0.40 to 0.82); days off work or school (odds ratio 0.55, 95% confidence interval 0.38 to 0. 79); and nocturnal asthma (odds ratio 0.53, 95% confidence interval 0.39 to 0.72). Measures of lung function were little changed. Self-management programmes that involved a written action plan showed a greater reduction in hospitalisation than those that did not (odds ratio 0.35, 95% confidence interval 0.18 to 0.68). People who managed their asthma by self-adjustment of their medications using an individualised written plan had better lung function than those whose medications were adjusted by a doctor.

Reviewer's conclusions: Training in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan appears to improve health outcomes for adults with asthma. Training programmes which enable people to adjust their medication using a written action plan appear to be more effective than other forms of asthma self-management.

PubMed Disclaimer

Conflict of interest statement

None

Figures

1
1
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
2
2
Forest plot of comparison: 1 Self Management versus Usual Care, outcome: 1.1 Hospitalisations (% subjects hospitalised).
3
3
Forest plot of comparison: 1 Self Management versus Usual Care, outcome: 1.3 ER Visits (% subjects).
1.1
1.1. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 1 Hospitalisations (% subjects hospitalised).
1.2
1.2. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 2 Hospitalisations (mean).
1.3
1.3. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 3 ER Visits (% subjects).
1.4
1.4. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 4 ER Visits (Mean).
1.5
1.5. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 5 Unscheduled Dr Visits (mean).
1.6
1.6. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 6 Unscheduled Dr Visits (% subjects).
1.7
1.7. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 7 Days off work (% subjects).
1.8
1.8. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 8 Days off work (mean).
1.9
1.9. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 9 Nocturnal Asthma (% subjects).
1.10
1.10. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 10 FEV1 (mean).
1.11
1.11. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 11 Peak Expiratory Flow (mean).
1.12
1.12. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 12 Hospitalisations (mean total days).
1.13
1.13. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 13 Rescue Medication Use (% subjects).
1.14
1.14. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 14 Quality of Life Total Score (mean).
1.15
1.15. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 15 Quality of Life Impact (mean).
1.16
1.16. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 16 Quality of Life Activity (mean).
1.17
1.17. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 17 Quality of Life Symptoms (mean).
1.18
1.18. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 18 Total Direct Costs (mean).
1.19
1.19. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 19 Total Indirect Costs (mean).
1.20
1.20. Analysis
Comparison 1 Self Management versus Usual Care, Outcome 20 Total Costs (mean).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Abdulwadud 1999 {published data only}
    1. Abdulwadud O, Abramson M, Forbes A, James A, Walters EH. Evaluation of a randomised controlled trial of adult asthma education in a hospital setting. Thorax 1999;54:493‐500. - PMC - PubMed
Allen 1995 {published data only}
    1. Allen RM, Jones MP, Oldenburg. Randomised trial of an asthma self‐management programme for adults. Thorax 1995;50:731‐8. - PMC - PubMed
Bailey 1990 {published data only}
    1. Bailey WC, Richards JM, Brooks CM, Soong S, Windsor RA, et al. A randomised trial to improve self‐management practice of adults with asthma. Archives of Internal Medicine 1990;150:1664‐8. - PubMed
    1. Bailey WC, Richards JM, Manzella BA, Windsor RA, Brooks CM, Soong SJ. Promoting self management in adults with asthma: an overview of the UAB program. Health Education Quarterly 1987;14:345‐55. - PubMed
    1. Windsor RA, Bailey WC, Richards JM, et al. Evaluation of the efficacy and cost effectiveness of health education methods to increase medication adherence among adults with asthma. American Journal of Public Health 1990;80:1519‐21. - PMC - PubMed
Bailey 1999 {published data only}
    1. Bailey WC, Kohler CL, Richards JM, Windsor RA, Brooks M, Gerald LB. Asthma self‐management: do patient education programs always have an impact?. Archives of Internal Medicine 1999;159:2422‐8. - PubMed
Berg 1997 {published data only}
    1. Berg J, Dunbar‐Jacob J, Sereika SM. An evaluation of a self‐management program for adults with asthma. Clinical Nursing Research 1997;6(3):225‐38. - PubMed
Blixen 2001 {published data only}
    1. Blixen CE, Hammel JP, Murphy D, Ault V. Feasibility of a nurse‐run asthma education program for urban African‐Americans: a pilot study. Journal of Asthma 2001;38(1):23‐32. - PubMed
Brewin 1995 {published data only}
    1. Brewin AM, Hughes JA. Effect of patient education on asthma management. British Journal of Nursing 1995;4:81‐101. - PubMed
Cote 1997 {published data only}
    1. Cote J, Cartier A, Robichaud P, Boutin H, Malo JI. Influence of asthma education on asthma severity, quality of life and environmental control. Canadian Respiratory Journal 2000;7(5):395‐400. - PubMed
    1. Cote J, Cartier A, Robichaud P, Poutin H, Malo J, Rouleau M, et al. Influence on Asthma Morbidity of asthma education programs based on self management plans following treatment optimization. American Journal of Respiratory & Critical Care Medicine 1997;155:1509‐14. - PubMed
Cowie 1997 {published data only}
    1. Cowie RL, Revitt SG, Underwood MF, Field SK. The effect of a peak flow‐based action plan in the prevention of exacerbations of asthma. Chest 1997;112:1134‐8. - PubMed
de Oliveira 1999 {published data only}
    1. Oliveira MA, Faresin SM, Bruno VF, Bittencourt AR, Fernandes ALG. Evaluation of an educational programme for socially deprived asthma patients. European Respiratory Journal 1999;14(4):908‐14. - PubMed
Gallefoss 1999 {published data only}
    1. Gallefoss F, Bakke PS. Cost‐effectiveness of self‐management in asthmatics: a 1yr follow‐up randomized, controlled trial. European Respiratory Journal 2001;17:206‐213. - PubMed
    1. Gallefoss F, Bakke PS. How does patient education and self‐management among asthmatics and patients with chronic obstructive pulmonary disease affect medication. American Journal of Respiratory & Critical Care Medicine 1999;160:2000‐5. - PubMed
    1. Gallefoss F, Bakke PS. Impact of patient education and self‐management on morbidity in asthmatics and patients with chronic obstructive pulmonary disease. Respiratory Medicine 2000;94:279‐87. - PubMed
    1. Gallefoss F, Bakke PS. Patient satisfaction with health care in asthmatics and patients with COPD before and after patient education. Respiratory Medicine 2000;94:1057‐1064. - PubMed
    1. Gallefoss F, Bakke PS, Kjaersgaard P. Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease. American Journal of Respiratory & Critical Care Medicine 1999;159:812‐7. - PubMed
Garret 1994 {published data only}
    1. Garrett J, Fenwick JM, Taylor G, Mitchell E, Stewart J, Rea H. Prospective controlled evaluation of the effect of a community based asthma education centre in a multiracial working class neighbourhood. Thorax 1994;49:976‐83. - PMC - PubMed
George 1999 {published data only}
    1. George MR, O'Dowd LC, Martin I, Lindell KO, Whitney F, Jones M, et al. A comprehensive educational progamme improves clinical outcome measures in inner‐city patients with asthma. Archives of Internal Medicine 1999;159:1710‐6. - PubMed
Ghosh 1998 {published data only}
    1. Ghosh CS, Ravindran P, Joshi M, Stearns SC. Reductions in hospital use from self management training for chronic asthmatics. Social Science & Medicine 1998;46(8):1087‐93. - PubMed
Grampian 1994 {published data only}
    1. Grampian Asthma Study of Integrated Care (GRASSIC) Effectiveness of routine self monitoring of peak flow in patients with asthma. Britich Medical Journal 1994;308:564‐7. - PMC - PubMed
Hayward 1996 {published data only}
    1. Hayward SA, Jordan M, Golden G, Levy M. A randomised controlled evaluation of asthma self management in general practice. Asthma in General practice 1996;4:11‐3.
Heard 1999 {published data only}
    1. Heard AR, Richards IJ, Alpers JH, Pilotto LS, Smith BJ, Black JA. Randomised controlled trial of general practice based asthma clinics. Medical Journal of Australia 1999;171:68‐71. - PubMed
Hilton 1986 {published data only}
    1. Hilton S, Sibbald B, Anderson HR, Freeling P. Controlled evaluation of the effects of patient education on asthma morbidity in general practice. The Lancet 1986;1:26‐9. - PubMed
Ignacio‐Garcia 1995 {published data only}
    1. Ignacio‐Garcia JM, Gonzalez‐Santos P. Asthma self‐management education program by home monitoring of peak expiratory flow. American Journal of Respiratory & Critical Care Medicine 1995;151:353‐9. - PubMed
Jones 1995 {published data only}
    1. Jones KP, Mullee MA, Middleton M, Chapman E, Holgate ST, British Society Research Committee. Peak flow based asthma self management: a randomised controlled study in general practice. Thorax 1995;50:851‐7. - PMC - PubMed
Knoell 1998 {published data only}
    1. Knoell DL, Pierson JF, Marsh CB, Allen JN, Pathak DS. Measurement of outcomes in adults receiving pharmaceutical care in a comprehensive asthma outpatient clinic. Pharmacotherapy 1998;18(6):1365‐74. - PubMed
Kotses 1995 {published data only}
    1. Kotses H, Bernstein IL, Bernstien DI, et al. A self‐management program for adult asthma. Part 1: development and evaluation. Journal of Allergy & Clinical Immunology 1995;95:529‐40. - PubMed
Kotses 1996 {published data only}
    1. Kotses H, Stout C, Mcconnaughty K, Winder JA, Creer TL. Evaluation of individualized asthma self‐management programmes. Journal of Asthma 1996;33:113‐8. - PubMed
Lahdensuo 1996 {published data only}
    1. Lahdensuo A, Haahtela T, Herrala J, et al. Randomised comparison of guided self‐management. British Medical Journal 1996;312:748‐52. - PMC - PubMed
    1. Lahdensuo A, Haahtela T, Herrala J, Kava T, Kiviranta K, Kuusisto P, et al. Randomised comparison of cost effectiveness of guided self management and traditional treatment of asthma in Finland. British Medical Journal 1998;316:1138‐9. - PMC - PubMed
Levy 2000 {published data only}
    1. Levy ML, Robb M, Allen J, Doherty C, Bland JM, Winter RJD. A randomized controlled evaluation of specialist nurse education following accident and emergency attendance for acute asthma. Respiratory Medicine 2000;94:900‐8. - PubMed
Mayo 1990 {published data only}
    1. Mayo PH, Richman J, Harris HW. Results of a program to reduce admissions for adult asthma. Annals of Internal Medicine 1990;112:864‐71. - PubMed
Moudgil 2000 {published data only}
    1. Moudgil H, Marshall T, Honeybourne D. Asthma education and quality of life in the community: a randomised controlled study to evaluate the impact on white European and Indian subcontinent ethnic groups from socio‐economically deprived areas in Birmingham, UK. Thorax 2000;55:177‐83. - PMC - PubMed
Mulloy 1996 {published data only}
    1. Mulloy E, Donaghy D, Quigley C, McNicholas WT. A one‐year prospective audit of an asthma education programme in an out‐patient setting. Irish Medical Journal 1996;89:226‐8. - PubMed
Neri 1996 {published data only}
    1. Neri M, Migliori GB, Spanevello A, Berra D, Nicolin E, Landoni CV, et al. Economic analysis of two structured treatment and teaching programs on asthma. Allergy 1996;51:313‐9. - PubMed
Schott‐Baer 1999 {published data only}
    1. Schott‐Baer D, Christensen M. Research for practice. A pilot programme to increase self‐care of adult asthma patients. Medsurg Nursing 1999;8:178‐83. - PubMed
Shields 1986 {published data only}
    1. Shields MC, Reinhard JD, Szidon JP, White PB. Effectiveness of a patient eduction program for adult asthmatics in reducing emergency room use. Clinical Research 1986;34(2).
    1. Shields MC, Vail MJ, Reinhard JD, Szidon JP, White PB. Counseling is better accepted than classes in patient education of adult inner city asthmatics. New Health Care Systems: HMOs & Beyond. 1986; Vol. June:289‐98.
Snyder 1987 {published data only}
    1. Snyder Se, Winder JA, Creer TL. Development and evaluation of an adult asthma self‐managment program: Wheezers Anonymous. Journal of Asthma 1987;11:39‐43. - PubMed
Sommaruga 1995 {published data only}
    1. Sommaruga M, Spanevello A, Migliori GB, Neri M, Callegari S, Manjani G. The effects of a cognitive behavioural intervention in asthmatic patients. Monaldi Archives for Chest Disease 1995;50:398‐402. - PubMed
Wilson 1993 {published data only}
    1. Nguyen BP, Wilson SR, German DF. Patients' perceptions compared with objective ratings of asthma severity. Annals of Allergy Asthma & Immunology 1996;77:209‐15. - PubMed
    1. Wilson SR, Scamagas P, German DF, Hughes GW, Lulla S, et al. A controlled trial of two forms of self‐managment education for adults with asthma. American Journal of Medicine 1993;94:564‐76. - PubMed
    1. Wilson‐Pessano ST, et al. An evaluation of approaches to asthma self management education for adults. The AIR/Kaiser Permanente study. Health Education Quarterly 1987;14:333‐43. - PubMed
Yoon 1993 {published data only}
    1. Yoon R, McKenzie DK, Bauman A, Miles DA. Controlled trial evaluation of an asthma education program for adults. Thorax 1993;48:1110‐6. - PMC - PubMed
Zeiger 1991 {published data only}
    1. Zeiger RS, Heller S, Mellon MH, Wald J. Falkoff R, Schatz M. Facilitated referral to asthma specialist reduces relapses in asthma emergency room visits. Journal of Allergy and Clinical Immunology 1991;87:1160‐8. - PubMed

References to studies excluded from this review

Abdulwadud 1997 {published data only}
    1. Abdulwadud O, Abramson M, Forbes A, James A, Light L, Thien F, Walters EH. Attendance at an asthma educational intervention: characteristics of participants and non‐participants. Respiratory Medicine 1997;91:524‐9. - PubMed
Adams 2001 {published data only}
    1. Adams RJ, Boath K, Homan S, Campbell DA, Ruffin RE. A randomised trial of peak‐flow and symptom‐based action plans in adults with moderate‐to‐severe asthma. Respirology 2001;6:297‐304. - PubMed
Aiolfi 1995 {published data only}
    1. Aiolfi S, Confalonieri M, Scartabellati A, Patrini G, Ghio L, Mauri F, et al. International guidelines and educational experiences in an out‐patient clinic for asthma. Monaldi Archives for Chest Disease 1995;50:477‐81. - PubMed
Amirav 1995 {published data only}
    1. Amirav I, Goren A, Kravitz RM, Pawlowski N. Physician‐tarteted program on inhaled therapy for childhood asthma. Journal of Allergy and Clinical Immunology 1995;95:818‐23. - PubMed
Ayres 1996 {published data only}
    1. Ayres JG, Campbell LM. A controlled assessment of an asthma self‐management plan involving a budesonide dose regimen. European Respiratory Journal 1996;9:886‐92. - PubMed
Baldwin 1997 {published data only}
    1. Baldwin DR, Pathak UA, King R, Vase BC, Pantin CFA. Outcome of asthmatics attending asthma clinics utilising self‐management plans in general practice. Asthma in General Practice 1997;5:31‐2.
Bolton 1991 {published data only}
    1. Bolton MB, Tilley BC, Kuder J, Reeeves T, Schultz LR. The cost and effectiveness of an education program for adults who have asthma. Journal of General Internal Medicine 1991;6:401‐7. - PubMed
    1. Ford ME, Havstad SL, Tilley BC, Bolton MB. Health outcomes among African and American Caucasian adults following a randomized trial of an asthma education program. Ethnicity & Health 1997;2(329‐39). - PubMed
Boulet 1995 {published data only}
    1. Boulet LP, Boutin H, Cote J, Leblanc P, Laviolettte M. Evaluation of an asthma self‐management program. Journal of Asthma 1995;32:199‐206. - PubMed
Charlton 1990 {published data only}
    1. Charlton I, Charlton G, Broomfield J, Mullee M. Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. British Medical Journal 1990;301:1355‐9. - PMC - PubMed
Cote 2001 {published data only}
    1. Cote J, Bowie DM, Robichaud P, Parent J‐G, Battiti L, Boulet L‐P. Evaluation of two different educational interventions for adult patients consulting with an acute asthma exacerbation. American Journal of Respiratory and Critical Care Medicine 2001;163:1415‐9. - PubMed
Cox 1993 {published data only}
    1. Cox NJM, Hendricks JC, Binkhorst Ra, Herwaarden CLA. A pulmonary rehabilitation program for patients with asthma and mild chronic obstructive pulmonary diseases (COPD). Lung 1993;171:235‐44. - PubMed
Erickson 1998 {published data only}
    1. Erickson SR, Ascione FJ, Kirking DM, Johnson CE. Use of a paging system to improve medication self‐management in patients with asthma. Journal of the American Pharmaceutical Association 1998;38:767‐9. - PubMed
Gergen 1995 {published data only}
    1. Gergen PJ, Goldstein RA. Does asthma education equal asthma intervention?. International Archives of Allergy & Immunology 1995;107:166‐8. - PubMed
Graft 1991 {published data only}
    1. Graft DF. A randomised trial to improve self‐management practices of adults with asthma: reviewers comments. Journal of Asthma 1991;28:228‐9.
Grainger‐Rousseau {published data only}
    1. Grainger‐Rousseau T‐J, McElnay JC. A model for community pharmacist involvement with general practitioners in the management of asthma patients. Journal of Applied Therapeutics 1996;1:145‐61.
Grampian 1994b {published data only}
    1. Grampian Asthma Study of Integrated Care (GRASSIC) Integrated care for asthma: a clinical, social, economic evaluation. British Medical Journal 1994;308:559‐64. - PMC - PubMed
Hausen 1999 {published data only}
    1. Hausen T. Patient education‐how can the long‐term effect be analyzed and how long does it last? (German). Pneumologie 1999;53:289‐95. - PubMed
Heringa 1987 {published data only}
    1. Heringa P, Lawson L, Reda D. The effects of a structured education program on knowledge and psychomotor skills of patients using Beclomethasone Dipropionate Aerosol for Steroid Dependent Asthma. Health Education Quarterly 1987;14:309‐17. - PubMed
Hindi‐Alexander 1987 {published data only}
    1. Hindi‐Alexander MC. Asthma education programs: their role in asthma morbidity and mortality. Journal of Allergy and Clinical Immunology 1986;80:492‐4. - PubMed
Hoskins 1996 {published data only}
    1. Hoskins G, Neville RG, Smith B, Clark RA. Do self‐management plans reduce morbidity in patients with asthma?. British Journal of General Practice 1996;46:169‐71. - PMC - PubMed
Huss 1992 {published data only}
    1. Huss K, Huss RW, Squire EN, et al. Computer education for asthmatics: What effects?. Journal of Nursing Care Quality 1992;6:57‐66. - PubMed
Jackevicius 1999 {published data only}
    1. Jackevicius CA, Chapman KR. Inhaler education do hospital based pharmacists: How much is required?. Canadian Respiratory Journal 1999;6:237‐44. - PubMed
Janson‐Bjerklie 1988 {published data only}
    1. Janson‐Bjerklie S, Shnell S. Effect of peak flow information on patterns of self‐care in adult asthma. Heart & Lung 1988;17:543‐9. - PubMed
Jenkinson 1988 {published data only}
    1. Jenkinson D, Davison J, Jones S, Hawtin P. Comaparison of effects of a self management booklet and audio cassette for patients with asthma. British Medical Journal 1988;297:267‐70. - PMC - PubMed
Jones 1987 {published data only}
    1. Jones PK, Jones SL, Katz J. Improving compliance for asthmatic patients visiting the emergency department using a health belief model. Journal of Asthma 1987;24:199‐206. - PubMed
Kauppinen 1998 {published data only}
    1. Kauppinen R, Sintonen H, Tukiainen H. One‐year economic evaluation of intensive versus conventional patient education and supervision for self‐management of new asthmatic patients. Respiratory Medicine 1998;92:300‐7. - PubMed
    1. Kauppinen R, Sintonen H, Vilkka V, Tukianen H. Long‐term (3‐year) economic evaluation of intensive patient education for self‐management during the first year in new asthmatics. Respiratory Medicine 1999;93:283‐9. - PubMed
    1. Kauppinen R, Vilkka V, Sintonen H, Klaukka T, Tukianen H. Long term economic evaluation of intensive patient education during the first treatment year in newly diagnosed asthma. Respiratory Medicine 2001;95:56‐63. - PubMed
Kelso 1995 {published data only}
    1. Kelso TM, Abou‐Shala N, Neilker GM, Arheart KL, Portner TS, Self TH. Comprehensive long‐term management program for asthma: effect on outcomes in adult African‐Americans. American Journal of the Medical Sciences 1996;311:272‐80. - PubMed
    1. Kelso TM, Self TH, Rumbak MJ, Stephens MA, Garrett W, Arheart KL. Educational and Long‐Term Therapeutic Intervention in the ED: Effect on Outcomes in Adult Indigent Minority Asthmatics. American Journal of Emergency Medicine 1995;13:632‐8. - PubMed
Klein 2001 {published data only}
    1. Klein JJ, Palen J, Uil SM, Zielhaus GA, Seydel ER, Herwaarden CLA. Benefit from the inclusion of self‐treatment guidelines to a self‐management programme for adults with asthma. European Respiratory Journal 2001;17:386‐394. - PubMed
LeBaron 1985 {published data only}
    1. LeBaron S, Zeltzer LK, Patner P, Kniker WT. A controlled study of education for improving compliance with Cromolyn Sodium (Intal): the importance of Physician‐patient communication. Annals of Allergy 1985;55:811‐8. - PubMed
Legorreta 2000 {published data only}
    1. Legorreta AP, Leung K‐M, Berkbigler D, Evans R, Liu X. Outcomes of a population‐based asthma management program: quality of life, absenteeism, and utilization. Annals of Allergy Asthma & Immunology 2000;85:28‐34. - PubMed
Lirsac 1991 {published data only}
    1. Lirsac B, Braunstein G. Randomised evaluation of two teaching methods using aerosol inhalers. Revue des Maladies Respiratories 1991;8:559‐65. - PubMed
Lopez‐Vina 2000 {published data only}
    1. Lopez‐Vina A, Castillo‐Arevalo F. Influence of peak expiratory flow monitoring on an asthma self‐management education programme. Respiratory Medicine 2000;94:760‐6. - PubMed
Maes 1988 {published data only}
    1. Maes S, Schlosser M. Changing health behaviour outcomes in asthmatic patients: A pilot intervention study. Social Science & Medicine 1988;26:359‐64. - PubMed
Maiman 1979 {published data only}
    1. Maiman LA, Green LW, Gibson G, MacKenzie EJ. Education for self‐treatment by adult asthmatics. The Journal of the American Medical Association 1979;241:1919‐22. - PubMed
Moldofsky 1979 {published data only}
    1. Moldofsky H, Broder I, Davies G, Leznoff A. Videotape educational program for people with asthma. Canadian Medical Association Journal 1979;120:669‐72. - PMC - PubMed
Muhlhauser 1991 {published data only}
    1. Muhlhauser I, Richter B, Kraut D, Weske G, Worth H, Berger M. Evaluation of a structured treatment and teaching programme of asthma. Journal of Internal Medicine 1991;230:157‐64. - PubMed
Osman 1994 {published data only}
    1. Osman LM, Abdalla MI, Beattie JAG, Ross SJ, Russell IT, Friend JA, et al. Reducing hospital admission through computer supported education for asthma patients. British Medical Journal 1994;308:568‐71. - PMC - PubMed
Perdomo‐Ponce 1996 {published data only}
    1. Perdomo‐Ponce D, Benarroch L, Gonzalez‐Cerrutti R, Barroso R, Carneiro F, Meijomil P. Family education, a model for allergy prevention [Spanish]. Investigacion Clinica 1996;37:221‐45. - PubMed
Petro 1995 {published data only}
    1. Petro W, Hollander P, Hamann B, Lauber B, Mzyk C, Prittwitz M. Patientenschulung in der pneumologischen Rehabilitation steigert den terapeutischen Erfolg. Atemwegs und Lungerkrankheiten 1995 Suppl;49‐58.
Premaratne 1999 {published data only}
    1. Premaratne UN, Sterne JAC, Marks GB, Webb R, Azima H, Burney PGJ. Clustered randomised trial of an intervention to improve the management of asthma: Greenwich asthma study. British Medical Journal 1999;318:1251‐5. - PMC - PubMed
Ringsberg 1990 {published data only}
    1. Ringsberg KC, Wiklund I, Wilhelmsen L. Education of adult patients at an "asthma school": effects on quality of life, knowledge and need for nursing. European Respiratory Journal 1990;3:33‐7. - PubMed
Rydman 1999 {published data only}
    1. Rydman RJ, Sonenthal K, Laksminarayana T, Butki N, McDermott, MF. Evaluating the outcome of two teaching methods of breath actuated inhaler in an inner city asthma clinic. Journal of Medical Systems 1999;23:349‐56. - PubMed
Sondergaard 1992 {published data only}
    1. Sondergaard B, Davidsen F, Kirkeby B, Rasmussen M, Hey H. The economics of an intensive educational programme for asthmatic patients. A prospective controlled trial. Pharmacoeconomics 1992;3:207‐12. - PubMed
Thapar 1994 {published data only}
    1. Thapar A. Educating asthmatic patients in primary care: a pilot study of small group education. Family Practice 1994;11:39‐43. - PubMed
Tougaard 1992 {published data only}
    1. Tougaard L, Krone T, Sorknaes, Ellegaard H, PASTMA group. Economic benefits of teaching patients with chronic obstructive pulmonary disease about their asthma. Lancet 1992;339:1517‐20. - PubMed
Turner 1998 {published data only}
    1. Turner MO, Taylor D, Bennett R, Fitzgerald JM. A randomized trial comparing peak expiratory flow and symptom self‐management plans for patients with asthma attending a primary care clinic. American Journal of Respiratory and Critical Care Medicine 1998;157:540‐6. - PubMed
Verver 1996 {published data only}
    1. Verver S, Poelman M, Bogels A, Chisholm SL, Dekker FW. Effects of instruction by practice assistance on inhaler technique and respiratory symptoms of patients. A controlled randomized videotaped intervention study. Family Practice 1996;13:35‐40. - PubMed
White 1989 {published data only}
    1. White PT, Pharoah CA, Anderson HR, Freeling P. Randomised controlled trial of small group education on the outcome of chronic asthma in general practice. Journal of the Royal College of General Practitioners 1989;39:182‐6. - PMC - PubMed

References to studies awaiting assessment

Im 1993 {published data only}
    1. Im J. Evaluation of effectiveness of an asthma clinic managed by an ambulatory care pharmacist. California Journal of Hospital Pharmacy 1993;5:5‐6.

References to ongoing studies

Ford 1996 {published data only}
    1. Ford ME, Edwards G, Rodrigues JL, Gibson RC, Tilley BC. An empowerment‐centered, church‐based asthma education program for African American adults. Health and Social Work 1996;21:70‐5. - PubMed
Ploska 1999 {published data only}
    1. Ploska JF. Asthma education nurses in the hospital (French) [Infirmiere educatrice de l'asthme en secteur hospitalier]. Revue de l Infirmiere 1999;50:35‐40. - PubMed

Additional references

Anonymous 1992
    1. Anonymous. International Consensus Report on Diagnosis and Treatment of Asthma. National Heart, Lung, and Blood Institute Bethesda, Maryland, 1992.
Anonymous 1996
    1. Annonymous. Asthma Management Handbook 1996.
Bernard‐Bonnin 1995
    1. Bernard‐Bonnin A, et al. Self‐management teaching programs and morbidity of pediatric asthma: a meta‐analysis. Journal of Allergy & Clinical Immunology 1995;95:23‐41. - PubMed
Clark 1993
    1. Clark NM, Gotsch A, Rosenstoc IR. Patient , professional and public education on behavioural aspects of asthma: a review of strategies for change and needed research. Journal of Asthma 1993;30:241‐55. - PubMed
Gibson 1993a
    1. Gibson PG, et al. A prospective audit of asthma management following emergency asthma treatment at a teaching hospital. Medical Journal of Australia 1993;158:775‐8. - PubMed
Gibson 1993b
    1. Gibson PG. Asthma guidelines and evidenced‐based medicine. Lancet 1993;342:1305. - PubMed
Gibson 1998
    1. Gibson PG, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, Bauman A, et al. The effects of limited (information‐only) asthma education on health outcomes of adults with asthma (Cochrane Review). The Cochrane Library 1998, Issue 1. [CD001005]
Peat 1994
    1. Peat JK, et al. Changing prevalence of asthma in Australian Children. British Medical Journal 1994;308:1591‐6. - PMC - PubMed
Woolcock 1989
    1. Woolcock A, et al. Asthma Managment Plan. Medical Journal of Australia 1989;151:650‐3. - PubMed

Publication types