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Effectiveness of a program of minimal educational intervention in asthma control and prevention of exacerbation (Prometheus)

Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, Barcelona, Espanya

BARCELONA

Nurse in charge: Meritxell Peiró i Fàbregas


Description

BACKGROUND

The current guides of clinical practice on asthma, national and international, catalogue the effectiveness of the educational programs with the highest possible level of evidence (A). But, in reality, the educational programs on asthma are not commonly used by the health professionals.

HYPOTHESIS

An educational program on asthma based on a reduced intervention, administered and managed by health professionals with a minimum educational training, should offer a decrease in morbidity and a better control of asthma in comparison with the current clinical practice.

OBJECTIVE

Determining the effectiveness – in terms of prevention of exacerbation (future risk) and improvement on asthma control (current control) – of an educational program based on a reduced or minimal intervention.

METHODOLOGY

Prospective, multicenter controlled study with center randomization. The cases included in it were distributed into three branches:

  • minimal intervention group (MIG), who received a minimal educational intervention.
  • ordinary clinical practice group (OCPG), who did not receive any type of specific education and constituted the control group (negative).
  • “gold standard” group (GSG), comprised of patients who received the training of a formal, structured educational program on asthma and who constituted another control group (positive).

The centers were previously randomized to assign their patients to one of the two first study branches. The patients were monitored for one year with a control every four months.

RESULTS

The clinical asthma control of the MIG improved considerably (p=0.037) in comparison with OCPG. Therefore, the evolution of the three types of intervention in time is not the same, as can be seen in graph 1, where a meaningful improvement in asthma control can be observed in the MIG and GSG in relation to the OCPG.

CONCLUSIONS

The educational program on asthma based on a reduced intervention is effective for asthma control and prevention of exacerbation, and it is similar to the classical structured programs, meaning that it could be a useful tool in its implementation to palliate the current underuse of the educational programs on asthma on the part of the health professionals.

 

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Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, Barcelona, Espanya

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