A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma

Liesl Marten Osman, Christine Calder, James Friend, J. G. Douglas, David John Godden, Lynda McKenzie, J. S. Legge

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: There is still debate over the benefit of self-management programmes for adults with asthma. A brief self-management programme given during a hospital admission for acute asthma was tested to determine whether it would reduce readmission.

Method: A randomised controlled trial was performed in 280 adult patients with acute asthma admitted over 29 months. Patients on the self-management programme (SMP) received 40-60 minutes of education supporting a written self-management plan. Control patients received standard care (SC).

Results: One month after discharge SMP patients were more likely than SC patients to report no daytime wheeze (OR 2.6, 95% CI 1.5 to 5.3), no night disturbance (OR 2.0, 95% CI 1.2 to 3.5), and no activity limitation (OR 1.5, 95% CI 0.9 to 2.7). Over 12 months 17% of SMP patients were re-admitted compared with 27% of SC patients (OR 0.5, 95% CI 0.3 to 1.0). Among first admission patients, OR readmission (SMP v SC) was 0.2 (95% CI 0.1 to 0.7), p<0.01. For patients with a previous admission, OR readmission was 0.8 (95% CI 0.4 to 1.6), p=0.6. SMP patients were more likely than SC patients to be prescribed inhaled steroids at discharge (99% v 92%, p=0.03), oral steroids (98% v 90%, p=0.06), and to have hospital follow up (98% v 84%, p<0.01) but adjustment for these differences did not diminish the effect of the self-management programme.

Conclusions: A brief self-management programme during hospital admission reduced post discharge morbidity and readmission for adult asthma patients. The benefit of the programme may have been greater for patients admitted for the first time. The programme also had a small but significant effect on medical management at discharge.

Original languageEnglish
Pages (from-to)869-874
Number of pages5
JournalThorax
Volume57
Issue number10
DOIs
Publication statusPublished - 2002

Keywords

  • EDUCATION-PROGRAM
  • DEPRIVATION
  • READMISSION
  • BUDESONIDE
  • MORBIDITY
  • SCOTLAND
  • PLANS
  • CARE

Cite this

Osman, L. M., Calder, C., Friend, J., Douglas, J. G., Godden, D. J., McKenzie, L., & Legge, J. S. (2002). A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma. Thorax, 57(10), 869-874. https://doi.org/10.1136/thorax.57.10.869

A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma. / Osman, Liesl Marten; Calder, Christine; Friend, James; Douglas, J. G.; Godden, David John; McKenzie, Lynda; Legge, J. S.

In: Thorax, Vol. 57, No. 10, 2002, p. 869-874.

Research output: Contribution to journalArticle

Osman, LM, Calder, C, Friend, J, Douglas, JG, Godden, DJ, McKenzie, L & Legge, JS 2002, 'A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma', Thorax, vol. 57, no. 10, pp. 869-874. https://doi.org/10.1136/thorax.57.10.869
Osman, Liesl Marten ; Calder, Christine ; Friend, James ; Douglas, J. G. ; Godden, David John ; McKenzie, Lynda ; Legge, J. S. / A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma. In: Thorax. 2002 ; Vol. 57, No. 10. pp. 869-874.
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abstract = "Background: There is still debate over the benefit of self-management programmes for adults with asthma. A brief self-management programme given during a hospital admission for acute asthma was tested to determine whether it would reduce readmission.Method: A randomised controlled trial was performed in 280 adult patients with acute asthma admitted over 29 months. Patients on the self-management programme (SMP) received 40-60 minutes of education supporting a written self-management plan. Control patients received standard care (SC).Results: One month after discharge SMP patients were more likely than SC patients to report no daytime wheeze (OR 2.6, 95{\%} CI 1.5 to 5.3), no night disturbance (OR 2.0, 95{\%} CI 1.2 to 3.5), and no activity limitation (OR 1.5, 95{\%} CI 0.9 to 2.7). Over 12 months 17{\%} of SMP patients were re-admitted compared with 27{\%} of SC patients (OR 0.5, 95{\%} CI 0.3 to 1.0). Among first admission patients, OR readmission (SMP v SC) was 0.2 (95{\%} CI 0.1 to 0.7), p<0.01. For patients with a previous admission, OR readmission was 0.8 (95{\%} CI 0.4 to 1.6), p=0.6. SMP patients were more likely than SC patients to be prescribed inhaled steroids at discharge (99{\%} v 92{\%}, p=0.03), oral steroids (98{\%} v 90{\%}, p=0.06), and to have hospital follow up (98{\%} v 84{\%}, p<0.01) but adjustment for these differences did not diminish the effect of the self-management programme.Conclusions: A brief self-management programme during hospital admission reduced post discharge morbidity and readmission for adult asthma patients. The benefit of the programme may have been greater for patients admitted for the first time. The programme also had a small but significant effect on medical management at discharge.",
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T1 - A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma

AU - Osman, Liesl Marten

AU - Calder, Christine

AU - Friend, James

AU - Douglas, J. G.

AU - Godden, David John

AU - McKenzie, Lynda

AU - Legge, J. S.

PY - 2002

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N2 - Background: There is still debate over the benefit of self-management programmes for adults with asthma. A brief self-management programme given during a hospital admission for acute asthma was tested to determine whether it would reduce readmission.Method: A randomised controlled trial was performed in 280 adult patients with acute asthma admitted over 29 months. Patients on the self-management programme (SMP) received 40-60 minutes of education supporting a written self-management plan. Control patients received standard care (SC).Results: One month after discharge SMP patients were more likely than SC patients to report no daytime wheeze (OR 2.6, 95% CI 1.5 to 5.3), no night disturbance (OR 2.0, 95% CI 1.2 to 3.5), and no activity limitation (OR 1.5, 95% CI 0.9 to 2.7). Over 12 months 17% of SMP patients were re-admitted compared with 27% of SC patients (OR 0.5, 95% CI 0.3 to 1.0). Among first admission patients, OR readmission (SMP v SC) was 0.2 (95% CI 0.1 to 0.7), p<0.01. For patients with a previous admission, OR readmission was 0.8 (95% CI 0.4 to 1.6), p=0.6. SMP patients were more likely than SC patients to be prescribed inhaled steroids at discharge (99% v 92%, p=0.03), oral steroids (98% v 90%, p=0.06), and to have hospital follow up (98% v 84%, p<0.01) but adjustment for these differences did not diminish the effect of the self-management programme.Conclusions: A brief self-management programme during hospital admission reduced post discharge morbidity and readmission for adult asthma patients. The benefit of the programme may have been greater for patients admitted for the first time. The programme also had a small but significant effect on medical management at discharge.

AB - Background: There is still debate over the benefit of self-management programmes for adults with asthma. A brief self-management programme given during a hospital admission for acute asthma was tested to determine whether it would reduce readmission.Method: A randomised controlled trial was performed in 280 adult patients with acute asthma admitted over 29 months. Patients on the self-management programme (SMP) received 40-60 minutes of education supporting a written self-management plan. Control patients received standard care (SC).Results: One month after discharge SMP patients were more likely than SC patients to report no daytime wheeze (OR 2.6, 95% CI 1.5 to 5.3), no night disturbance (OR 2.0, 95% CI 1.2 to 3.5), and no activity limitation (OR 1.5, 95% CI 0.9 to 2.7). Over 12 months 17% of SMP patients were re-admitted compared with 27% of SC patients (OR 0.5, 95% CI 0.3 to 1.0). Among first admission patients, OR readmission (SMP v SC) was 0.2 (95% CI 0.1 to 0.7), p<0.01. For patients with a previous admission, OR readmission was 0.8 (95% CI 0.4 to 1.6), p=0.6. SMP patients were more likely than SC patients to be prescribed inhaled steroids at discharge (99% v 92%, p=0.03), oral steroids (98% v 90%, p=0.06), and to have hospital follow up (98% v 84%, p<0.01) but adjustment for these differences did not diminish the effect of the self-management programme.Conclusions: A brief self-management programme during hospital admission reduced post discharge morbidity and readmission for adult asthma patients. The benefit of the programme may have been greater for patients admitted for the first time. The programme also had a small but significant effect on medical management at discharge.

KW - EDUCATION-PROGRAM

KW - DEPRIVATION

KW - READMISSION

KW - BUDESONIDE

KW - MORBIDITY

KW - SCOTLAND

KW - PLANS

KW - CARE

U2 - 10.1136/thorax.57.10.869

DO - 10.1136/thorax.57.10.869

M3 - Article

VL - 57

SP - 869

EP - 874

JO - Thorax

JF - Thorax

SN - 0040-6376

IS - 10

ER -