Effect of asthma self management programme on asthma morbidity and health care utilization in adult patients admitted to hospital with acute asthma in Hong Kong: A randomised controlled trial

Abstract

Introduction Asthma is major cause of morbidity in Hong Kong. Asthma self-management plan has been shown beneficial in reducing asthma morbidity, use of health services and even mortality in studies in many parts of the world. However, data on the effectiveness of such programme in Hong Kong are lacking. Study Objectives To evaluate the effectiveness of an asthma selfmanagement programme on asthma-related use of medical services, absenteeism from work and morbidity in patients admitted to the Queen Mary Hospital for acute asthma in Hong Kong. Method Patients were randomized into the intervention and the control group, and followed up for 12 months. The intervention group received the Asthma Self-management Program with a written self-action plan and usual care while the control group received only usual care. Both groups were given asthma education. Comparisons of outcomes at 12 months were made between the 2 groups with respect to the ratio of asthma related hospitalization, A&E visits, visits to general practitioners, days off work, asthma symptomatology, use of medications and lung function. Results Forty patients were randomised into the intervention and 36 into the control group. Both groups have comparable baseline characteristics and similar rate of lost to follow up (~13%). At 12 month, patients in the intervention group were significantly less likely to have cumulative days off work or off school (RR = 0.23, 95% CI: 0.13 to 0.34) and unscheduled doctor visits (RR = 0.60, 95% CI: 0.30 to 1.00). There were no significant differences in the incidence of hospitalization, A&E visits, frequency of asthma symptoms and lung function between the two groups. Conclusion Asthma self-management plan is an acceptable and effective way of reducing asthma related absenteeism from work and unscheduled visits to doctors. It should be included in the management of adult patients with asthma in Hong Kong.