Impacto de uma intervenção educacional de curta duração sobre a adesão ao tratamento e controle da asma Impact of a short-term educational intervention on adherence to asthma treatment and on asthma control

Abstract

OBJETIVO: Avaliar o efeito de um programa educativo individualizado de curta duração para asma sobre a adesão ao tratamento, técnicas inalatórias e controle da doença. MÉTODOS: Estudo prospectivo em duas fases (antes e depois da intervenção) em pacientes com idade > 14 anos e com diagnóstico confirmado de asma, recrutados no ambulatório especializado de um hospital universitário em Porto Alegre (RS). Durante a visita médica de rotina, os participantes responderam um questionário geral para avaliar o nível de controle da asma e a técnica inalatória e foram submetidos a testes de função pulmonar. Participaram, então, de um programa educativo em asma que consistiu de uma sessão individualizada. A reavaliação ocorreu em três meses. RESULTADOS: Dos 174 pacientes recrutados, 115 completaram o estudo. Entre as avaliações, houve uma melhora significativa no uso efetivo de corticosteroides inalatórios (90,4% vs. 93,3%; p = 0,003), no uso efetivo de β2-agonistas de longa ação (57,4% vs. 63,5%; p OBJECTIVE: To evaluate the effect of a short-term individualized education program on adherence to asthma treatment, inhalation techniques, and asthma control. METHODS: A prospective study involving patients aged 14 years or older, with a confirmed diagnosis of asthma and recruited from the asthma outpatient clinic of a university hospital in the city of Porto Alegre, Brazil. The study was conducted in two phases (before and after the educational intervention). At a routine medical visit, the participants completed a general questionnaire in order to assess the level of asthma control and inhalation techniques. The participants also underwent pulmonary function testing. Subsequently, they participated in an asthma education program, which consisted of one individualized session. The participants were reevaluated after three months. RESULTS: Of the 174 patients recruited, 115 completed the study. Between the first and second evaluations, there was a significant improvement in the effective use of inhaled corticosteroids (90.4% vs. 93.3%; p = 0.003), the effective use of long-acting β2 agonists (57.4% vs. 63.5%; p < 0.0001), the effective use of a combined regimen with these two medications (57.4% vs. 62.6%; p < 0.0001), and the self-reported adherence to corticosteroid therapy (p = 0.001). There was a significant decrease in the proportion of patients visiting ERs (30.4% vs. 23.5%; p = 0.012). However, the level of asthma control and the inhalation technique did not improve significantly (p = 0.095 and p = 0.512, respectively). CONCLUSIONS: This short-term asthma education program resulted in an improvement in the use of medications for asthma control and a decrease in the number of ER visits, although it had no significant effect on the inhalation technique.

Keywords

• Assistência ambulatorial
• Educação de pacientes como assunto
• Terapia respiratória
• Inaladores dosimetrados
• Ambulatory care
• Patient education as topic
• Respiratory therapy
• Metered dose inhalers