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Characteristics of Existing Asthma Self-Management Education Packages

Technical Brief, No. 35

Investigators: , M.S., M.A., , M.P.H., , M.D., , R.N., B.S.N., , M.D., and , M.D., M.Sc.

Rockville (MD): Agency for Healthcare Research and Quality (US); .
Report No.: 20-EHC008

Structured Abstract

Background:

As the prevalence and burden of asthma continues to grow, so does the need to identify and invest resources in effective interventions. Asthma self-management education (AS-ME) packages facilitate knowledge and self-care for asthma patients and families. Many AS-ME interventions are widely studied, but uncertainty remains about optimal design, characteristics, and implementation. Heterogeneity in format, delivery mechanisms, target audiences, and other features complicates efforts to identify best practices in designing AS-ME packages.

Purpose:

To identify components of AS-ME packages, and examine, compare, and organize key characteristics and available research to improve understanding of current practice and future needs.

Methods:

Existing AS-ME packages were identified, acquired, and reviewed. Major characteristics were evaluated, including population, audience, setting, delivery mechanism, and content. Key Informants were interviewed to identify contextual factors affecting development and implementation of AS-ME packages. A systematic literature review was conducted to identify and synthesize current research.

Findings:

We reviewed 14 AS-ME packages for adults, adolescents, children, and parents, designed for use in schools, community-based sites, healthcare facilities, or patient homes. Most packages facilitate education in-person with an instructor, while a few are self-directed. Learning materials are typically paper based, and few packages incorporate audiovisual or online content. Most packages are available in English and Spanish, and most are free. Packages address asthma knowledge, medication and device use, symptom management, and asthma triggers. Most packages are generally up to date.

Implementation of AS-ME packages varies widely. Most packages were developed or disseminated by a few professional or patient advocacy organizations. Instructors often tailor packages to local settings and many homegrown packages also exist.

We reviewed 7 systematic reviews and 33 primary studies published since 2007. Half evaluated school-based packages, while the others examined home or community settings. Most studies were conducted in children or adolescents. Frequently reported outcomes include asthma control, asthma knowledge, symptoms, quality of life, hospitalizations, and emergency department use. AS-ME packages were generally associated with improved asthma control, reduced symptom frequency, increased asthma knowledge, and fewer school absences. Results were mixed when examining hospitalizations, emergency department visits, and quality of life.

Conclusions:

A robust choice of branded AS-ME packages exists for many patient populations and settings, although these vary in structure, delivery, and accessibility. Homegrown packages are also common but not widely shared. Further research on home-based and adult-focused packages is needed.

Contents

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857; www.ahrq.gov Contract No. 290-2015-00005-I Prepared by: ECRI Institute – Penn Medicine Evidence-based Practice Center, Philadelphia, PA

Suggested citation:

Leas BF, Tipton K, Bryant-Stephens T, Jackson-Ware M, Mull N, Tsou AY. Characteristics of Existing Asthma Self-Management Packages. Technical Brief No. 35. (Prepared by ECRI Institute – Penn Medicine EPC under Contract No. 290-2015-00005.) AHRQ Publication No. 20-EHC008. Rockville, MD: Agency for Healthcare Research and Quality; April 2020. doi: https://0-doi-org.brum.beds.ac.uk/10.23970/AHRQEPCTB35. Posted final reports are located on the Effective Health Care Program search page.

This report is based on research conducted by the ECRI Institute – Penn Medicine Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00005) with funding provided by the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ, CDC, or of the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help healthcare decision makers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of healthcare services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.

AHRQ, CDC, or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies may not be stated or implied.

This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program website at www.effectivehealthcare.ahrq.gov. Search on the title of the report.

Bookshelf ID: NBK556503PMID: 32369313

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