[Education of the adult asthmatic]

Abstract

This article aims to examine educational strategies in the context of the overall management of the asthmatic patient. The objectives are analysed from the viewpoints of the both the patient and the health care professionnal. The complexity of the manifestations of asthma and the variability of perception of symptoms require a personalised approach to education. The asthmatic patients, co-operation with their therapeutic management, in particular in matters of compliance, reveals problems common to other chronic conditions. If an agreement can be reached during an exchange of beliefs and points of view, this will lead to the most appropriate choice of therapy. The evaluation of educational strategies has been the subject of many publications and sequential studies must be distinguished from randomised controlled trials. Sequential studies of educational strategies generally include severe asthmatics, previously under-treated. The improvement in measured parameters of morbidity is often striking but it is difficult to separate the true effect of education from that of improved total management, particularly the introduction of preventative treatment. Randomised trials with an "uneducated" control group give more conflicting results. A particular emphasis may be placed on action plans based on monitoring of peak flow and/or symptoms. Finally the inclusion of educational strategies in the training programmes of health care professionnals is now well established and its impact should be evaluated.