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
Randomized Controlled Trial
. 2016 Dec 28;11(12):e0158783.
doi: 10.1371/journal.pone.0158783. eCollection 2016.

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS)

Chris Griffiths  1 , Stephen Bremner  1 , Kamrul Islam  1 , Ratna Sohanpal  1 , Debi-Lee Vidal  1 , Carolyn Dawson  1 , Gillian Foster  1 , Jean Ramsay  1 , Gene Feder  2 , Stephanie Taylor  1 , Neil Barnes  1   3 , Aklak Choudhury  1 , Geoff Packe  4 , Elizabeth Bayliss  5 , Duncan Trathen  6 , Philip Moss  7 , Viv Cook  1 , Anna Eleri Livingstone  1 , Sandra Eldridge  1
Affiliations
Randomized Controlled Trial

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS)

Chris Griffiths et al. PLoS One. .

Abstract

Background: People with asthma from ethnic minority groups experience significant morbidity. Culturally-specific interventions to reduce asthma morbidity are rare. We tested the hypothesis that a culturally-specific education programme, adapted from promising theory-based interventions developed in the USA, would reduce unscheduled care for South Asians with asthma in the UK.

Methods: A cluster randomised controlled trial, set in two east London boroughs. 105 of 107 eligible general practices were randomised to usual care or the education programme. Participants were south Asians with asthma aged 3 years and older with recent unscheduled care. The programme had two components: the Physician Asthma Care Education (PACE) programme and the Chronic Disease Self Management Programme (CDSMP), targeted at clinicians and patients with asthma respectively. Both were culturally adapted for south Asians with asthma. Specialist nurses, and primary care teams from intervention practices were trained using the PACE programme. South Asian participants attended an outpatient appointment; those registered with intervention practices received self-management training from PACE-trained specialist nurses, a follow-up appointment with PACE-trained primary care practices, and an invitation to attend the CDSMP. Patients from control practices received usual care. Primary outcome was unscheduled care.

Findings: 375 south Asians with asthma from 84 general practices took part, 183 registered with intervention practices and 192 with control practices. Primary outcome data were available for 358/375 (95.5%) of participants. The intervention had no effect on time to first unscheduled attendance for asthma (Adjusted Hazard Ratio AHR = 1.19 95% CI 0.92 to 1.53). Time to first review in primary care was reduced (AHR = 2.22, (1.67 to 2.95). Asthma-related quality of life and self-efficacy were improved at 3 months (adjusted mean difference -2.56, (-3.89 to -1.24); 0.44, (0.05 to 0.82) respectively.

Conclusions: A multi-component education programme adapted for south Asians with asthma did not reduce unscheduled care but did improve follow-up in primary care, self-efficacy and quality of life. More effective interventions are needed for south Asians with asthma.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Adaptation of educational programmes
Fig 2
Fig 2. Flow of practices and patients through the study
Fig 3
Fig 3. Kaplan-Meier estimate of probability of attending for first episode of unscheduled asthma care by days since intervention
Fig 4
Fig 4. Kaplan-Meier estimate of probability of attending for first asthma review by days since intervention
See this image and copyright information in PMC

References

    1. Erickson SE, Iribarren C, Tolstykh IV, Blanc PD, Eisner MD. Effect of race on asthma management and outcomes in a large, integrated managed care organization. Arch Intern Med. 2007;167(17):1846–52. 10.1001/archinte.167.17.1846 - DOI - PubMed
    1. Netuveli G, Hurwitz B, Levy M, Fletcher M, Barnes G, Durham SR, et al. Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis. The Lancet. 365(9456):312–7. - PubMed
    1. Hull SA, McKibben S, Homer K, Taylor SJ, Pike K, Griffiths C. Asthma prescribing, ethnicity and risk of hospital admission: an analysis of 35,864 linked primary and secondary care records in East London. NPJ Prim Care Respir Med. 2016;26:16049 PubMed Central PMCID: PMCPMC4989925. 10.1038/npjpcrm.2016.49 - DOI - PMC - PubMed
    1. Sheikh A, Steiner MF, Cezard G, Bansal N, Fischbacher C, Simpson CR, et al. Ethnic variations in asthma hospital admission, readmission and death: a retrospective, national cohort study of 4.62 million people in Scotland. BMC Med. 2016;14(1):3. PubMed Central PMCID: PMCPMC4710027. - PMC - PubMed
    1. Griffiths C, Kaur G, Gantley M, Feder G, Hillier S, Goddard J, et al. Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study. Bmj. 2001;323(7319):962–6. PubMed Central PMCID: PMC59689. - PMC - PubMed

Publication types