MedWire News: Good knowledge of disease management is not enough to reduce emergency department visits in patients with asthma and chronic obstructive pulmonary disease (COPD), say researchers who suggest that patient education should also focus on behavioral change.
“A key component of management guidelines in asthma and COPD is the recommendation for patient education,” explain Margareta Emtner (Uppsala University, Sweden) and team in the journal Pulmonary Medicine.
However, they add: “Although disease severity and psycho-social factors are well known contributors to asthma and COPD morbidity, the influence of education and patient knowledge have received less attention.”
To investigate further, the researchers assessed patient characteristics, education and disease knowledge among in 84 patients with asthma and 52 with COPD who had visited the emergency room (ER) at Uppsala University hospital because of an exacerbation.
The patients, who were aged at least 18 years, underwent structured telephone interviews in which information was gathered on demographic characteristics, smoking history, formal education levels, physical activity levels, employment status, medication use, comorbidity, and prior ER visits and hospitalizations. They were also asked whether they had received patient education (individual or in a group setting), and their disease knowledge was assessed.
The participants were then followed-up for 1 year and all those who had repeat ER visits were identified.
The researchers found that 67% of patients with COPD had at least one more ER visit during the following year compared with 42% of those with asthma.
Although around 80% of the patients had received information from health professionals or participated in education/rehabilitation, less than 20% had good knowledge about managing their condition. Patients with good knowledge tended to be younger, were more likely to have asthma than COPD, and had a higher educational background than those with less knowledge.
However, after accounting for gender, diagnosis, age, and educational background, there were no significant differences regarding patient education and knowledge between patients with and without further ER visits.
Emtner and team conclude: “Patients with asthma had a better self reported knowledge of disease management and were less likely to have new exacerbations than patients with COPD. Reported level of knowledge was, however, in itself not a predictor of exacerbations.”
They add: “This indicates that information is not sufficient to reduce the burden of disease. Patient education focused on self-management and behavioral change should be emphasized.”
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