Can Education for South Asians With Asthma and Their Clinicians Reduce Unscheduled Care? A Randomised Trial

Summary

People from ethnic minority groups suffer worse ill-health from asthma than those from majority groups. No studies have reduced emergency care for people from minority groups. We have developed an education programme to address barriers to improved care for south Asian people with asthma. The study is set in Tower Hamlets and Newham - the UK's most deprived and ethnically diverse boroughs. We will invite all the local GP practices to take part, and using a computer programme, randomised them (like tossing a coin) into two groups - a group receiving usual care and a group receiving our educational programme. This comprises:

* Education for specialist nurse and GPs and practice nurses, using our adaptation of an American education course, designed to improve shared-decision making, goal-setting and patient-clinician partnership.
* Lay-led 'expert-patient' education in small groups for patients, using an adaptation of another American course.
* Improved follow-up in primary care through appointment-booking by the specialist nurse.We will invite south Asians aged 3-65 years with asthma after A\&E attendance or hospital admission to take part. Those registered with practices receiving the educational programme will see the trial specialist nurse in a nurse-run clinic, where the nurse:

1. provides self-management advice and a treatment plan,
2. makes a follow-up appointment in primary care
3. makes an appointment for lay-led 'expert-patient' sessions.Patients registered with 'usual care' practices receive usual care.

We will decide if our education programme works by comparing the number of emergency visits to GPs and hospital between the two groups.

Conditions

• Asthma

Interventions

BEHAVIORAL

PACE (Professional Asthma Care Education)

Education for intervention specialist nurse and GPs and practice nurses from intervention practices, using our adaptation of Clarke's self-regulation education programme, designed to improve shared-decision making, goal-setting and patient-clinician partnership.

BEHAVIORAL

Lay Led Expert Patient Programme

Lay-led 'expert-patient' education in small groups for patients, using an adaptation of Stanford University's chronic disease self-management programme.

BEHAVIORAL

Asthma self management education by a specialist nurse

asthma education and self management, asthma action plans

Sponsors & Collaborators

• Asthma UK

  collaborator OTHER

• Social Action for Health

  collaborator UNKNOWN

• Department of Health (Service Support - host acute/community)

  collaborator UNKNOWN

• Noreen Clarke, Professor of Public Health, Michigan University

  collaborator OTHER

• Barts & The London NHS Trust

  lead OTHER

Principal Investigators

• Chris Griffiths, MB BS, DPhil · Queen Mary's School of medicine and Dentistry

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

3 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2005-11-30

Primary Completion

2008-04-30

Completion

2009-04-30

Countries

• United Kingdom

Study Locations