[Asthma education]

[Use of the reliable change index to evaluate the effectiveness of clinical interventions: Application of an asthma training program]

OBJECTIVE

To compare two methods for the evaluation of outcomes to assess effectiveness of a therapeutic intervention of a professional education program on asthma control.

DESIGN

A naturalistic, intervention study in which asthmatic patients were attended by clinicians (IG group) who Had taken part in a special education program and a control group (CG) that received medical assistance from clinicians still waiting to be trained.

LOCATION

Five urban Primary Care Health Centres of the same region.

PARTICIPANTS

From an initial sample of 100 patients, 76 formed the final sample for analysis. The study included 37 males and 39 females, aged between 18 and 65 years (M=41.2 years). The two study groups were found to be homogeneous except for the sex variable.

INTERVENTION

Training program for clinical treatment adherence.

MAIN MEASUREMENTS

Peak flow as spirometric index, and structured interview.

STATISTICAL ANALYSIS

The results were initially analysed using classical techniques based on robust ANOVA models, and then by calculating the Reliable Change Index (RCI).

RESULTS

ANOVA models, conducted separately for each sex, showed no significant differences, due to sample size. RCI methodology showed significant differences in the percentage of patients improved in both groups, as well as clinically relevant changes being observed individually.

CONCLUSIONS

The RCI method is presented as an attractive alternative as regards the classical methods of analysis that can help in the clinical decision.

[Effectiveness of therapeutic education and respiratory rehabilitation programs for the patient with asthma]

Asthma is a chronic complex and heterogeneous disease, with great variability and has a huge impact, not only on patients who suffer the disease but also their families and society in general. The education of the asthmatic patient and their families is essential for therapeutic intervention. Through continuous, dynamic and adaptive education, changes in attitudes and behaviours of the patient and family can be achieved, and will undoubtedly lead to an improvement in their quality of life. Among other non-pharmacological interventions, respiratory rehabilitation is an alternative treatment, and is primarily aimed at patients with moderate to severe asthma. Although the latest clinical practice guidelines published in the scientific literature recommend two strategies for treatment, the results of relevant publications are diverse. The objective of this study was to describe the effectiveness of therapeutic and educational programs in respiratory rehabilitation of the asthmatic patient.