How to Improve Teaching About Asthma
Although there has been a significant increase in knowledge about the physiopathogenesis of asthma and an improvement in therapeutic modalities, the mortality rate for the disease has increased in many countries over the last two decades. Previous studies showed that deaths due to asthma may be preventable in 60 to 80% of cases. Potentially avoidable factors have been identified, such as failure to adhere to prescribed therapies, under recognition of asthma severity, underutilization of self-monitoring in assessment of airway obstruction, lack of a plan of action to manage asthma flare-ups, and delay in medical treatment during acute attacks.
Furthermore, although it is unacceptable, mortality from asthma represents only a small fraction of the problem, while asthma-related morbidity is tremendous and still seems to be on the increase. For instance, in the United States, the direct cost related to asthma, including hospitalizations, emergency department visits, physicians’ services, and medication was $6.2 billion in 1990. Reduced productivity related to absenteeism from work and school represented the largest indirect cost, approaching $1.6 billion. In Canada, the estimated annual cost for hospitalization due to asthma for 1988 to 1989 was more than $120 million read only tadanafil. A recent Canadian survey showed that during the past decade, mortality from asthma has remained stable, while the number of hospitalizations for asthma has increased, especially in patients younger than 35 years of age.
Although there is no definitive explanation for the increase in asthma mortality and morbidity, it is widely believed that patient education might help to decrease them.” However, some barriers must be overcome before a greater number of asthmatic subjects can gain access to effective asthma education programs. Our focus is on the needs and requirements of asthma educators and on the problems they encounter.
Asthma education can improve knowledge about asthma, compliance with treatment, asthma control, self-assessment skills, and relationships with the physician and other health professionals. Programs promoting early intervention during asthma exacerbations have been more successful in improving control over asthma than those aimed only at improving knowledge.” Specific aspects of asthma education have been evaluated; for example, after participation in an asthma education program, 80% of the patients were able to use their inhalation device properly compared with 10% before. Different reviews of asthma education programs have been published, as reported elsewhere in these proceedings.