Reduction in asthma morbidity following a community-based asthma self-management programme in Tonga

Int J Tuberc Lung Dis. 2009 Jan;13(1):142-7.

Abstract

Background: The Tonga Asthma Self-management Project assessed whether the introduction of an asthma self-management plan would reduce asthma morbidity.

Methods: The project involved a 'before and after' trial, with each participant serving as his/her own control. Asthma patients used the self-management plan to manage their asthma medication or obtain medical help based on their peak expiratory flow (PEF) rate and/or asthma symptoms.

Results: The 110 participants initially had relatively high asthma morbidity: 68% had had an emergency medical visit for asthma in the previous 12 months. Ninety-two (84%) completed the 12-month programme. Emergency doctor visits fell from 66% in the previous 12 months to 18% (P < 0.001) in the following 12 months. Other measures also improved, including hospital admissions (from 19% to 3%, P = 0.001), having 14 days or more 'out of action' (from 29% to 4%, P < 0.001), waking > or = 2 nights a week (from 40% to 13%, P < 0.001), severe asthma attacks (from 54% to 18%, P < 0.001) and mean PEF rates (from 341 l/min to 417 l/min, a 22% increase, P < 0.001).

Conclusions: The potential benefits of asthma self-management plans and community-based asthma education are supported by the findings of the Tonga study. Their implementation is essential in the resource-scarce Pacific health setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Albuterol / administration & dosage
  • Asthma / drug therapy
  • Asthma / prevention & control*
  • Child
  • Disease Management*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers / statistics & numerical data
  • Peak Expiratory Flow Rate
  • Self Care*
  • Tonga
  • Young Adult

Substances

  • Albuterol