Background: Low participation limits the effectiveness
of patient education interventions. In this study, the characteristics
of patients who agreed to participate in a clinical trial of disease
self-management education for asthma were compared to the
characteristics of those who declined, and among the former group
patients who actually attended were compared to those who did not.
Methods: The education program, implemented at the Geneva
University Hospitals between 1996 and 1998, consisted of three
interactive sessions spread over 3 weeks. Only 131 of 253 eligible
patients (52%) agreed to participate in the trial, and only 83
patients (63%) attended two to three educational sessions. All
eligible patients filled out baseline questionnaires and were
interviewed by a trained physiotherapist.
Lower confidence in the patient’s own current treatment regimen and a
more severe baseline asthma attack were independently associated with
participation in the trial. Among those who agreed to participate in
the study, a university education, longer asthma duration, older age,
and a higher level of asthma management knowledge were associated with
higher attendance. Quality-of-life scores were not associated with
higher course attendance. Among all eligible participants, persons with
lower knowledge of asthma management (which was assessed by what to do
during an asthma attack and knowledge of the correct use of a peak
expiratory flowmeter and inhalers) were less likely to enroll in the
trial and to attend the educational training sessions.
Conclusions: Strategies need to be developed to
motivate patients with lower disease self-management knowledge to
participate in asthma education programs.