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Does smoking affect the outcome of patient education and self-management in asthmatics? [with consumer summary]
Gallefoss F, Bakke PS
Patient Education and Counseling 2003 Jan;49(1):91-97
clinical trial
2/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Information on the potential effect of smoking on the outcome of patient education in asthma is lacking. We randomly allocated 78 asthmatics to either a control or intervention group. Intervention consisted of two 2-h group sessions followed by 1 to 2 individual sessions each by a nurse and a physiotherapist. Self-management was emphasised following a stepwise treatment plan at exacerbations. Smokers experienced more general practitioner (GP) visits (p = 0.001) and absenteeism from work (p = 0.02), a greater need for rescue medication (p = 0.03), a larger drop in FEV1 (p = 0.02) and worse St George's respiratory questionnaire (SGRQ) scores (p < 0.001) compared to non-smokers during the 1-year follow-up. In multiple linear and logistic regression models smoking was still associated with worse SGRQ scores, a drop in FEV1, higher need for GP visits and rescue medication and higher total costs. We, thus, conclude that smoking was associated with reduced health related quality of life, a drop in FEV1, increased need for rescue medication and GP visits and higher costs after patient education during the 1-year follow-up, compared to no smoking.
With permission from Excerpta Medica Inc.

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