Reducing hospital admission through computer supported education for asthma patients
Abstract Objective : To evaluate a personalised computer supported education programme for asthma patients. Design : Pragmatic randomised trial comparing outcomes over 12 months between patients taking part in an enhanced education programme (four personalised booklets, sent by post) and patients re...
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| Veröffentlicht in: | BMJ 1994-02, Vol.308 (6928), p.568-571 |
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| creator | Osman, L M Abdalla, M I Beattie, J A G Ross, S J Russell, I T Friend, J A Legge, J S Douglas, J G |
| description | Abstract Objective : To evaluate a personalised computer supported education programme for asthma patients. Design : Pragmatic randomised trial comparing outcomes over 12 months between patients taking part in an enhanced education programme (four personalised booklets, sent by post) and patients receiving conventional oral education at outpatient or surgery visits. Setting : Hospital outpatient clinics and general practices in north east Scotland. Subjects : 801 adults attending hospital outpatient clinics, with a diagnosis of asthma confirmed by a chest physician and pulmonary function reversibility of at least 20%. Main outcome measures : Numbers of hospital admissions, consultations with general practioner for asthma, steroid courses used, bronchodilators and inhaled steroids prescribed, days of restricted activity, and disturbed nights. Results : Patients with asthma judged too severe for randomisation between clinic care and integrated care and thuse retained in clinic care had 54% fewer hospital admissions after receiving enhanced education than did the control group (95% confidence interval 30% to 97%; P |
| doi_str_mv | 10.1136/bmj.308.6928.568 |
| format | Article |
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Design : Pragmatic randomised trial comparing outcomes over 12 months between patients taking part in an enhanced education programme (four personalised booklets, sent by post) and patients receiving conventional oral education at outpatient or surgery visits. Setting : Hospital outpatient clinics and general practices in north east Scotland. Subjects : 801 adults attending hospital outpatient clinics, with a diagnosis of asthma confirmed by a chest physician and pulmonary function reversibility of at least 20%. Main outcome measures : Numbers of hospital admissions, consultations with general practioner for asthma, steroid courses used, bronchodilators and inhaled steroids prescribed, days of restricted activity, and disturbed nights. Results : Patients with asthma judged too severe for randomisation between clinic care and integrated care and thuse retained in clinic care had 54% fewer hospital admissions after receiving enhanced education than did the control group (95% confidence interval 30% to 97%; P<0.05) over the study year. Patients had not all spent a full year as “educated” patients within the study year: when “educated days” were controlled for, annual admission rates for the entire enhanced education group were 49% (31% to 78%) of those in the control group. Among patients with sleep variation, sleep disturbance in the education group in the week before a regular review was 80% (65% to 97%) of that in the control group. There was no significant difference in days of restricted activity, prescription of bronchodilators or inhaled steroids, use of oral steroids, or number of general practioner consultations for asthma, and no significant interaction between ownership of a peak flow meter and education. Conclusions : An asthma education programme based on computerised booklets can reduce hospital admissions and improve morbidity among hospital outpatients.</description><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.308.6928.568</identifier><identifier>PMID: 8093148</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Asthma ; Clinical outcomes ; Clinics ; Confidence interval ; Control groups ; Educational programs ; Flowmeters ; Health outcomes ; Hospital admissions ; Hospital costs ; Intervention ; Morbidity ; Patient education ; Personal computers ; Software ; Steroids ; Studies ; Symptoms</subject><ispartof>BMJ, 1994-02, Vol.308 (6928), p.568-571</ispartof><rights>1994 BMJ Publishing Group Ltd.</rights><rights>Copyright 1994 British Medical Journal</rights><rights>Copyright: 1994 (c) 1994 BMJ Publishing Group Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b439t-14c08a66580d680a7f87565f7612ca002a59b285d321ed754990cad8432335303</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/29722712$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/29722712$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids></links><search><creatorcontrib>Osman, L M</creatorcontrib><creatorcontrib>Abdalla, M I</creatorcontrib><creatorcontrib>Beattie, J A G</creatorcontrib><creatorcontrib>Ross, S J</creatorcontrib><creatorcontrib>Russell, I T</creatorcontrib><creatorcontrib>Friend, J A</creatorcontrib><creatorcontrib>Legge, J S</creatorcontrib><creatorcontrib>Douglas, J G</creatorcontrib><creatorcontrib>Grampian Asthma Study Of Integrated Care (GRASSIC)</creatorcontrib><title>Reducing hospital admission through computer supported education for asthma patients</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Abstract Objective : To evaluate a personalised computer supported education programme for asthma patients. Design : Pragmatic randomised trial comparing outcomes over 12 months between patients taking part in an enhanced education programme (four personalised booklets, sent by post) and patients receiving conventional oral education at outpatient or surgery visits. Setting : Hospital outpatient clinics and general practices in north east Scotland. Subjects : 801 adults attending hospital outpatient clinics, with a diagnosis of asthma confirmed by a chest physician and pulmonary function reversibility of at least 20%. Main outcome measures : Numbers of hospital admissions, consultations with general practioner for asthma, steroid courses used, bronchodilators and inhaled steroids prescribed, days of restricted activity, and disturbed nights. Results : Patients with asthma judged too severe for randomisation between clinic care and integrated care and thuse retained in clinic care had 54% fewer hospital admissions after receiving enhanced education than did the control group (95% confidence interval 30% to 97%; P<0.05) over the study year. Patients had not all spent a full year as “educated” patients within the study year: when “educated days” were controlled for, annual admission rates for the entire enhanced education group were 49% (31% to 78%) of those in the control group. Among patients with sleep variation, sleep disturbance in the education group in the week before a regular review was 80% (65% to 97%) of that in the control group. There was no significant difference in days of restricted activity, prescription of bronchodilators or inhaled steroids, use of oral steroids, or number of general practioner consultations for asthma, and no significant interaction between ownership of a peak flow meter and education. Conclusions : An asthma education programme based on computerised booklets can reduce hospital admissions and improve morbidity among hospital outpatients.</description><subject>Asthma</subject><subject>Clinical outcomes</subject><subject>Clinics</subject><subject>Confidence interval</subject><subject>Control groups</subject><subject>Educational programs</subject><subject>Flowmeters</subject><subject>Health outcomes</subject><subject>Hospital admissions</subject><subject>Hospital costs</subject><subject>Intervention</subject><subject>Morbidity</subject><subject>Patient education</subject><subject>Personal computers</subject><subject>Software</subject><subject>Steroids</subject><subject>Studies</subject><subject>Symptoms</subject><issn>0959-8138</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkM1r3DAQxUVoSZYk91wChhx6KN5IGksaHcsm_aAhgZD2KrS2nPVmbbmSDM1_XxmXHHqpLgN6vzfzeIRcMLpmDOT1tt-vgeJaao5rIfGIrFglsRQI8I6sqBa6RAZ4Qs5j3FNKOSjUUhyTY6QaWIUr8vTomqnuhudi5-PYJXsobNN3MXZ-KNIu-Ol5V9S-H6fkQhGncfQhuaaYXTbNUOtDYWPa9bYY848bUjwj71t7iO787zwlPz7fPm2-lncPX75tPt2V2wp0KllVU7RSCqSNRGpVi0pI0SrJeG1zXCv0lqNogDPXKFFpTWvbYAUcQACFU_Jh2TsG_2tyMZmcvHaHgx2cn6JREjRoIVQmr_4h934KQw5nmMqPIlWYKbpQdfAxBteaMXS9Da-GUTNXbnLlJldu5spNrjxbLhfLPiYf3niuFeeK8ayXi97F5H6_6Ta8GKlACXP_c2Nuvgu10TdgZOY_Lvx86b_X_wAkWpfj</recordid><startdate>19940226</startdate><enddate>19940226</enddate><creator>Osman, L M</creator><creator>Abdalla, M I</creator><creator>Beattie, J A G</creator><creator>Ross, S J</creator><creator>Russell, I T</creator><creator>Friend, J A</creator><creator>Legge, J S</creator><creator>Douglas, J G</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>19940226</creationdate><title>Reducing hospital admission through computer supported education for asthma patients</title><author>Osman, L M ; 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Design : Pragmatic randomised trial comparing outcomes over 12 months between patients taking part in an enhanced education programme (four personalised booklets, sent by post) and patients receiving conventional oral education at outpatient or surgery visits. Setting : Hospital outpatient clinics and general practices in north east Scotland. Subjects : 801 adults attending hospital outpatient clinics, with a diagnosis of asthma confirmed by a chest physician and pulmonary function reversibility of at least 20%. Main outcome measures : Numbers of hospital admissions, consultations with general practioner for asthma, steroid courses used, bronchodilators and inhaled steroids prescribed, days of restricted activity, and disturbed nights. Results : Patients with asthma judged too severe for randomisation between clinic care and integrated care and thuse retained in clinic care had 54% fewer hospital admissions after receiving enhanced education than did the control group (95% confidence interval 30% to 97%; P<0.05) over the study year. Patients had not all spent a full year as “educated” patients within the study year: when “educated days” were controlled for, annual admission rates for the entire enhanced education group were 49% (31% to 78%) of those in the control group. Among patients with sleep variation, sleep disturbance in the education group in the week before a regular review was 80% (65% to 97%) of that in the control group. There was no significant difference in days of restricted activity, prescription of bronchodilators or inhaled steroids, use of oral steroids, or number of general practioner consultations for asthma, and no significant interaction between ownership of a peak flow meter and education. Conclusions : An asthma education programme based on computerised booklets can reduce hospital admissions and improve morbidity among hospital outpatients.</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>8093148</pmid><doi>10.1136/bmj.308.6928.568</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0959-8138 |
| ispartof | BMJ, 1994-02, Vol.308 (6928), p.568-571 |
| issn | 0959-8138 1468-5833 1756-1833 |
| language | eng |
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| source | Jstor Complete Legacy; Alma/SFX Local Collection |
| subjects | Asthma Clinical outcomes Clinics Confidence interval Control groups Educational programs Flowmeters Health outcomes Hospital admissions Hospital costs Intervention Morbidity Patient education Personal computers Software Steroids Studies Symptoms |
| title | Reducing hospital admission through computer supported education for asthma patients |
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