Individualized programme to promote self-care among older adults with asthma: Randomized controlled trial

Aim. This paper is a report of a trial to examine the effectiveness of individualized self-care education programmes in older adults with moderate-to-severe asthma. Background. Asthma is a common chronic disease in adults and a major cause of frequent work absences, emergency room visits, and hospitalization. The results of studies of self-care education programmes have been largely supportive and suggest that they have positive outcomes for people with asthma. However, for older people with asthma, the effectiveness of computer-aided, self-learning video programmes has been controversial. Methods. Older adult patients with asthma (N = 148) were randomly assigned to one of three groups: usual care, individualized education, or individualized education with peak flow monitoring, and followed for 6 months. Data were collected from January to December 2006. The variables studied included demographic data, asthma self-care competence, asthma self-efficacy, and asthma self-care behaviour. Findings. Patients in both individualized education groups reported higher asthma self-care competence scores (F = 334·06 and 481·37, P < 0·001) and asthma self-care and self-efficacy scores (F = 104·08 and 68·42, P < 0·001) than patients in the usual care group. In addition, patients who received individualized education with peak flow monitoring had statistically significantly higher asthma self-care behaviour and self-efficacy scores (P < 0·001) and asthma control indicators (P = 0·025) than the education alone group. No differences were found among the three groups in unscheduled health service usage. Conclusion. Our results suggest that individualized education helps older people with asthma to enhance their self-care behaviours, manage their disease, and increase their quality of life.