A SELF-MANAGEMENT PROGRAM FOR ADULT ASTHMA .1. DEVELOPMENT AND EVALUATION

Background: We developed and evaluated a self-management program for adult asthma. In developing the program, we considered questions of format and behavior control. The for-mat we selected included components known to be effective in educational settings. We regulated asthma management behavior through the introduction of environmental cues. Methods: Seventy-six subjects, whose asthma was generally under medical control, were assigned randomly to either a treatment group or a waiting-list control group. Those in the treatment group were exposed to a 7-week program that incorporated proven features of providing effective training and establishing behavioral control. Subsequently, subjects in the control group received the treatment. Short-term evaluation of the treatment was made after the subjects in the experimental group were trained but before the control subjects were trained. Long-term evaluation was conducted after both groups of subjects were trained. Results: Over the short term, self-management training led to fewer. asthma symptoms and physician visits and improvement in asthma management skills and cognitive abilities. Over the long term, self-management training was related to lower asthma attack frequency, reduced medication use, improvement in cognitive measures, and increased use of self-management skills. Conclusions: The program improved asthma management in patients whose conditions were already under good medical control. The effects of the program were apparent a year after the conclusion of self-management training.