Trial of Lay-led Individualised Self-management Education for Adults With Asthma
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      Long term conditions often necessitate long term care. In many cases, giving control of their
      conditions to the patients themselves produces the best outcomes. Such patient education and
      the acquisition of self-management skills can be time consuming and the evidence suggests
      that the process is often not undertaken by doctors. Sometimes it is delegated to nursing
      colleagues, but all health professionals are in short supply. Patients carry credibility as a
      resource and this project is designed to determine, by means of a multi-centre randomised
      controlled trial, whether well trained lay educators can deliver training in self-management
      education to others with asthma, with outcomes equivalent to those achievable by a nurse.
    

Detailed description: 
      This study will be a randomised controlled trial looking for equivalence; the investigators'
      central hypothesis is that lay-led education will be at least equivalent to professional-led
      education in terms of patient outcomes. Patients will be randomised to receive either lay-led
      or professional led self-management education. Patients will be followed up longitudinally
      for 12 months from initial intervention. Two sites were studied; Manchester and London. It is
      anticipated that 16 sites will be recruited in each of the two geographical areas; all sites
      will have an asthma register. Individuals will be eligible for inclusion if they are adults;
      have clinician diagnosed asthma; have persistent disease and require regular therapy, with
      some evidence of variability in their disease, such that a self management plan would be
      appropriate. Both genders will be eligible, as will those unable to see or read. Individuals
      will be excluded if they have severe cognitive impairment; they decline to be randomised;
      they decline to receive asthma education and follow-up solely from the designated educator,
      other than in an emergency situation, or their condition does not show variability.

      The intervention in the study will be a disease-specific asthma self-management education
      programme delivery either by a professional (ie practice nurse) or a lay educator. Both lay
      and professional trainers will receive specific training in the content and delivery of this
      intervention. The intervention will consist of an initial 45 minute training session
      (including receipt of a written personal asthma action plan); a second face to face
      reinforcing session 3 weeks after the first session; 3 monthly telephone follow-up
      appointments to reinforce messages and to give ongoing advice with availability of the nurse
      or lay educator as a source of advice at all other times. Data will be collected on
      unscheduled use of health care, peak flow readings, patients' self-reporting of "adverse
      events", RCP three questions, perceptions of the interviews using MISS-21, QOL questionnaire
      and AQLQ. Demographics for all patients will also be recorded.
    

Intervention name(s): Self management education
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Asthma