Comparative Study Of The Influence Of Three Self-Management Methods On Disease Control Of Bronchial Asthma Patients

Objective:To compare and evaluate the influence of asthma disease control targets of asthma patients after using the Asthma ControlTest(ACT),the peak flow meter monitoring of peak expiratory flow values(PEF) and the ACT combine PEF. To compare the accuracy of self-assessment of asthma control level after accepting respectively the three self-management education methods.Methods:Data from125non-acute exacerbation of asthma patients who were treated in the first affiliated hospital of Guangxi medical university from July2010to June2011. The patients were randomly divided into ACT group who were guided the use of ACT-based self-management education(n=45),PEF group who were guided the use of peak flow meter monitoring of PEF-baesd self-management education(n=41),ACT and PEF group who were guided the use of ACT in combination with the peak flow meter monitoring of PEF-baesd self-management education (n=39).Study period of6months, the daily average daytime and nighttime asthma symptom scores, the values of FEV1, the daily average times of using short-acting β2-agonists, were used to assess the level of asthma control,the changes of these were assessed after3and6months. The incidence of asthma and the average times of delaying work or study in6months were assessed after months.The difference of patient self-evaluation and expert evaluation of two methods were also assessed after3and6months.Results:1The asthma control indicators in every group have significant statistical differences after3,6months (P<0.05); the daily average daytime and nighttime asthma symptom scores, the values of FEV1, the daily average times of using short-acting (32-agonists of ACT group in June was no-significant statistical differences compared with March (P>0.05).Asthma control level of the other two groups were all significantly improved (P<0.05).2The daily average daytime and nighttime asthma symptom scores, the FEV1, the daily average times of using emergency medicine in the ACT and PEF group had improved remarkably than other two groups(P <0.05) after3and6months.3The frequency of acute exacerbations of moderate or severe asthma, emergency department visits,hospitalization and the average times of delaying work or study of the ACT and PEF group had reduced remarkably in6months (P<0.05).4After3months,the PEF group of patients self-evaluation and expert evaluation of the two evaluation methods are statistically differences (P<0.05),and the other two groups have no significant differenc(P>0.05). After6months, the ACT group have significant differenc(P<0.05),and others have no significant differenc(P>0.05).Conclusion:1The three kinds of self-management methods are all effective to the control of asthma.2Patients to accept and grasp the self-management method of peak flow meter for monitoring PEF correctly,it takes some times.But insisted on using the longer,the better to asthma control.3The self-management method of ACT used in assessment of typical symptoms of asthma is better.4The method of using ACT and PEF is the most effective in the three kinds of self-management methods,it can reduce asthma symptoms, reduce the use of emergency medicine, improved lung function, most conducive to patients with accurate self-evaluation.