Disease management programmes for adults with asthma improve outcomes

Cochrane: Encouraging evidence indicates that programmes can improve quality of life and severity of asthma, and lung function. Asthma is a chronic airway disease affecting about 300 million people worldwide. People with asthma have many symptoms, such as wheezing, coughing, and shortness of breath. The aim of a chronic disease management programme for asthma is to go beyond simple patient education; they encompass a variety of interventions that centre on patients' needs, focus on helping the patients to manage their illness themselves, and provide them with information to understand their illness. Programmes also encourage the better co-ordination of health service professionals such as doctors and nurses.

A team of Cochrane authors, based in Switzerland and working with Cochrane’s Effective Practice and Organisation of Care Group, set out to study the effectiveness of chronic disease management programmes for adults over 16 years old age with a diagnosis  of asthma. Included in their review were 20 studies involving 81,746 patients. Patients had moderate to severe asthma. The overall quality of the evidence was moderate to low, due to limitations in design and the wide confidence intervals for certain results.
The results provide evidence of the potential effectiveness of these chronic disease management programmes for adults with asthma when compared with usual care. The evidence showed the programmes resulted in improvements in asthma-specific quality of life, reduced asthma severity scores, and improved breathing after 12 months.
“We wanted to know if chronic disease programmes were more effective than usual care for adults with asthma. We found encouraging evidence that these programmes improve outcomes for patients. Quality of life scores improved and we also saw an improvement in both lung function and the severity of their asthma. Both healthcare professionals and adults with asthma may want to take this evidence into consideration when planning care,” said Isabelle Peytremann-Bridevaux, a researcher at the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland, and the lead author of the Cochrane Review. “We recommend that future studies on asthma programmes study the optimal composition programmes and how they compare to patient and self-management education.”