Authors: Foliaki, S.¹; Fakakovikaetau, T.²; D'Souza, W.³; Latu, S.²; Tutone, V.; Cheng, S.; Pearce, N.

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 1, January 2009 , pp. 142-147(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

BACKGROUND: The Tonga Asthma Self-management Project assessed whether the introduction of an asthma self-management plan would reduce asthma morbidity.

METHODS: The project involved a `before and after' trial, with each participant serving as his/her own control. Asthma patients used the self-management plan to manage their asthma medication or obtain medical help based on their peak expiratory flow (PEF) rate and/or asthma symptoms.

RESULTS: The 110 participants initially had relatively high asthma morbidity: 68% had had an emergency medical visit for asthma in the previous 12 months. Ninety-two (84%) completed the 12-month programme. Emergency doctor visits fell from 66% in the previous 12 months to 18% (P < 0.001) in the following 12 months. Other measures also improved, including hospital admissions (from 19% to 3%, P = 0.001), having 14 days or more `out of action' (from 29% to 4%, P < 0.001), waking ≥2 nights a week (from 40% to 13%, P < 0.001), severe asthma attacks (from 54% to 18%, P < 0.001) and mean PEF rates (from 341 l/min to 417 l/min, a 22% increase, P < 0.001).

CONCLUSIONS: The potential benefits of asthma self-management plans and community-based asthma education are supported by the findings of the Tonga study. Their implementation is essential in the resource-scarce Pacific health setting.

Keywords: asthma; self-management; management

Document Type: Regular paper

Affiliations: 1: Ministry of Health, Nuku'alofa, Kingdom of Tonga; Centre for Public Health Research, Massey University, Wellington, New Zealand 2: Ministry of Health, Nuku'alofa, Kingdom of Tonga 3: Centre for Public Health Research, Massey University, Wellington, New Zealand; and Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia

Publication date: 2009-01-01

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