Authors' objectives:

This report aims to assess the effectiveness of self-management programs for obstructive respiratory problems. The evaluation deals with asthma and COPD separately.

Authors' recommendations: For the adult population, asthma self-management programs are an accepted and effective approach with strong evidence for their role in decreasing several indicators of morbidity, including number of nocturnal asthma attacks, unscheduled visits to the doctor, emergency room visits, hospitalizations, and days of absenteeism. According to the experts, patients with insufficient control of their asthma should be the target group at highest priority during the systematic establishment of self-management programs. The implementation of these programs must favour organizational models that permit close collaboration between attending physicians - particularly those in private clinics - and educators in asthma education centres. Evaluative research should be carried out to measure the effectiveness of self-management programs in terms of quality of life and reduction in health services utilization. Concerning the role of self-management programs for asthma in the pediatric population, available information concerning their efficacy is conflicting. Since these programs are already in use, it would be inappropriate to modify their operation at this point. The situation can be re-examined in the light of results that will be provided by a meta-analysis, currently under preparation, which integrates the most recent published data for this age group. Finally, for patients with COPD, preliminary results from a rigorous study suggest that they might benefit from the self-management approach. However, these results on efficacy remain to be confirmed by other studies or in the context of selective implementation projects, inasmuch as these initiatives are closely followed and generate data that will permit better specification of indications for use and the evaluation of effectiveness. This stage, if proven conclusive, may then lead to a gradual and coordinated implementation of self-management programs for COPD in more varied settings.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.aetmis.gouv.qc.ca/

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Agence d'évaluation des technologies et des modes d'intervention en santé

Contact Address: 2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Agence d'Evaluation des technologies et des Modes d'Intervention en Sante (AETMIS)