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Individual and community level asthma self-management: the Tonga Self-Management Programme

dianagosalvez Diana Gosálvez Prados — 27/09/2012

Other Organization

A review of 36 randomised trials has shown that self-management can improve outcomes for
patients with asthma.8 The Tonga Asthma Self-Management Programme encourages a greater
degree of self-management than was involved with most of the trials included in the study.
The programme aims to enable patients to manage their own condition with little or no
clinical supervision.


Goals Detection:
Shows new evidence on the importance of early detection, including guidelines of effective practices
Goals Treatment:
Promotes the appropriate use of medicines , It facilitates the management by processes
Goals self-management:
Refocuses the health system to support self-management , Allows home care

At the beginning of the programme, patients attended a clinic and were given instruction on
using peak expiratory flow (PEF) meters and recording the results. Patients were given a plan
on how to manage their asthma according to their PEF rates. The plan involved two different
self-assessment methods: the first was used in conjunction with the PEF rates, and the second
according to symptoms. Guidelines were then provided on how to respond.

The programme was assessed in a before-and-after trial, with each patient serving as his or her
own control. Patients used their self-management plan to manage their asthma medication or to
obtain medical advice on their PEF rate and any presenting symptoms. The 110 participants in
the study had moderate to severe asthma.

A total of 92 patients (84%) completed the 12-month programme. About two-thirds of them had
had an emergency medical visit for asthma in the previous 12 months, but during the 12 months
of the programme itself, just 18% had an emergency visit, with hospital admissions dropping
from 19% to 3%. Patients having more than 14 days “out of action” fell from 40% to 13%, and
severe asthma attacks fell from 54% to 18%.




Kingdom of Tonga

Practices Map



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