Abstract
Self-management education is a cornerstone of routine asthma care. To improve asthma knowledge and self-efficacy and to assess effects in patients with depressive symptoms. In a randomized trial, controls received asthma brochures and social support through frequent follow-up visits. Intervention patients made a contract to adopt a behavior to improve asthma and received a workbook, weekly reinforcements for 12 weeks, and frequent follow-up visits. Outcomes were Asthma Quality of Life Questionnaire (AQLQ) and 36-Item Short Form Health Survey (SF-36) scores and emergency department (ED) visits and hospitalizations for asthma. Ninety patients were randomized to each group. Mean age was 43 years, 84% were women, and mean study time was 27 months. Intervention patients had more improvement in AQLQ scores at 5 months, but this difference was not sustained. For the entire period, AQLQ scores improved by a clinically important difference from 4.1 to a mean of 5.1 in both groups (P < .001) with no difference between groups (P = .91). In multivariate analysis, younger age, more education, better enrollment AQLQ score, more asthma self-efficacy and knowledge, and fewer depressive symptoms were associated with more improvement (P < .05 fo...Continue Reading
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