Asthma train emergency personnel encourages referrals to therapeutic education

Train emergency personnel in the interest of patient education in the management of asthma makes when he sees patients for acute severe asthma, encourage them to participate in an education program shows A Canadian study published in "Chest".

Passages to emergency services for acute severe asthma appear to reflect poor control of the disease most often due to patient education and inadequate medical care, remember Patricia Robichaud hospital Laval Sainte-Foy (Quebec) colleagues.

However, few patients are offered to participate in a therapeutic education program when passing emergency. However, studies have shown that this process can reduce the morbidity and the use of emergency care.

In this study funded in part by the Canadian Ministry of Health, these doctors have developed a new program to increase patient participation in patient education. This program aims to ensure that emergency personnel routinely directs each patient it supports to therapeutic education centers.

For this, the ER staff is first formed specifically to asthma, its treatment and the interest of patient education in order to motivate patients and their families. A monitoring committee was also set up.

The program was launched in nine acute care centers that serve all a large number of asthmatic patients.

During the first four months, 1104 patients were referred to a therapeutic education center, against only 110 for the same period last year, showing that emergency personnel quickly joined this point in their practices.

Nearly half of these patients (48%) went to the emergency room more than twice a year.

Of the 1104 patients, 63.5% had made an appointment with a patient education center, 17.8% could not be contacted and 18.7% refused to participate in an education program. Among the 701 patients who made an appointment, came to 66.7%, slightly higher participation among those under 18 (67.4% against 59.8%).

An evaluation questionnaire to emergency personnel shows that knowledge about asthma and its management have increased after training.

In general, health professionals say they have little time after completing their normal work, to provide patients with short educational interventions, doctors note.

Implementing and maintaining such a program, however, seem limited by specific emergency department (number of patients treated, priorities) characteristics, therapeutic education Home center capacity, financial resources, lack of specialist support in some centers, joints between different interventions must achieve health professionals and previous participation in an education program.

Doctors note in particular that the time between referral to an education center and telephone contact with the patient was relatively long, about a month on average.

These results show that the ER staff is interested in a program to improve the participation of asthmatic patients to treatment education, leading to a significant increase in the number of referrals to the centers of education, said the doctors.

They hope that such a program, applied on a large scale, will reduce asthma morbidity and quality of life of patients. Analyzes are ongoing.