Education and Health in Asthmatics - Essay Example

The outcome to be evaluated was the effect of proper education of patients/family on self-care in adult asthmatics.
The ‘Medline’ database was studied with directed and pointed queries in the main search box for terms related to the clinical question. The first query was made using a rather obvious sentence ‘improving functional status in adult asthmatics’ but it yielded no results.

The search was repeated using a more targeted collection of terms ‘asthma control in adults’ which yielded some very good results. The primary papers shortlisted in this search which were somewhat relevant to the clinical question included papers on medical adherence amongst adult asthmatics residing in two inner city clinics, the beliefs of patients as well as physicians about asthma control, and the risks involved. Another search was conducted on the same website using ‘asthma self-care as the keyword. This yielded several hits and two papers talked about the impact of education on asthma patients, adults as well as children. Out of these, one was found to be highly relevant to the clinical question and is summarized below. Yet another search with the keywords ‘asthma medication’ yielded quite good results and another paper was selected for discussion and summarization. In total 10 relevant studies were obtained in this search. The two selected studies had high relevance to the clinical question due to their focus on the impact of education on patient adherence with medication for asthma and are therefore summarized below:

Summaries
1. A descriptive and correlative study tried to examine the impact of education, knowledge, and patient characteristics on emergency visits to the hospital which can yield some fair knowledge about the clinical question (Emtner et al, 2009). In a year-long study, 84 asthma patients and 52 COPD (Chronic Obstructive Pulmonary Disease) patients were interviewed on phone 4 to 6 weeks after an emergency room (ER) visit and followed up for one year to study the impact of patient knowledge about the respective disease. It was discovered that patients with asthma belonged to a younger age group and were more capable of handling their condition as compared to patients with COPD, who were older and had several comorbidities that complicated their situation. Although 80% of the patients had been educated about their diseases in rehabilitation programs, only <20% agreed that their knowledge about the disease was good. Patients who had good knowledge tended to be younger and were patients of asthma, rather than COPD. This was reflected in the less number of ER visits by asthma patients during the duration of the study. It was concluded by the authors that the patients with asthma had better self-reported knowledge of their condition and were less likely to visit the ER (Emtner et al, 2009).
2. In another study on medication adherence in asthmatics, a methodological approach was used to study the phenomenon in X inner city hospitals by using a 10-item self-reported scale of measurement, which was assessed for its validity to convey the right information (Cohen et al, 2009).

The study focused on the adherence to the use of inhaled corticosteroids (ICS) by asthmatics in two inner-city clinics. The tool used was the ‘Medication Adherence Report Scale for Asthma’ (MARS-A), which was tested on data obtained from 318 asthmatic adults. Self-reported adherence with the corticosteroid therapy was measured at baseline and after the elapse of one and three months. The percentage of days the patients used ICS was calculated electronically to yield internal validity, criterion validity and construct validity data after shortlisting patients with good adherence. The data was analyzed to find out what attributes contributed to better adherence to the medication. It was found that good psychometric performance was the right self-reported adherence measure for ICS therapy in both English as well as Spanish-speaking low-income group patients (Cohen et al, 2009).
The above two articles address the clinical question most appropriately as it was proved in the first one that better education led to fewer emergency room visits by asthma patients as they were found quite capable of handling the therapeutic regimen suggested to them at home. The second article measures the self-reported evaluation of adherence with medication suggested and prescribed for asthmatics. Although the validity of the method used for evaluation was the main criterion in this article, it still addresses the clinical question as completing such a questionnaire itself suggests the capability of the respondents as an educated and informed group. Both studies suggest that education and prior exposure to rehabilitation programs at the hospital do have an improvement in patient compliance and better outcomes in asthmatics. Read More