I knew it.
I knew it, I knew it, I knew it, and you guys did, too.
Yesterday I read a fantastic piece of research just published in Thorax, and normally I save this kind of thing for Saturday Links but I just have to give it its own post. See, some British researchers wondered if well-trained regular folks could educate patients about asthma as well as nurses. They thoroughly trained 15 people on asthma, and then 567 patients in 39 clinics received asthma education and consultation from either one of the trainees or a nurse (without knowing which one, naturally).
You know where this is going, right?
After one year, here’s the breakdown: 29.8% of patients under nurse care and 30.5% of patients under lay people’s care needed *unscheduled care* after one year. That’s virtually no difference. Even better, patients reported average satisfaction under both types of care.
Here’s how researcher Martyn Partridge describes the results:
“We have demonstrated that such education can be given by well-trained lay persons, with outcomes comparable to those achieved by practice nurses.”
This study pleases me enormously, although I don’t mean to detract from nursing. A good nurse can make or break a hospital experience–for asthma or otherwise–like nothing else, and I’ve encountered some truly excellent, compassionate, knowledgeable ones.
However, with such large gaps between what an asthma patient or parent needs to know and what some of them actually learn in a clinical setting (see: the 10-second guideline for inhalers), we absolutely need new ways to increase patient knowledge.
This is the dirty little secret about asthma that’s not such a secret:
When asthma is diagnosed in our children or ourselves, many of us are given little to no direction in learning about it.
Asthma is usually so treatable, yet plenty of us spend years with very sick children, not even understanding the nature of the disease. It’s startling, the difference between my life with a severe, undertreated asthmatic child and a well-controlled moderate persistent one, and the achingly frustrating part is that it doesn’t have to be this way. For anyone.
Because asthma resources are all over the Internet. Lack of information is not the problem. Not knowing you should go read that information, is.
Look, I recognize that plenty of doctors and nurses have heavy patient loads and therefore often lack the time to run through a quick asthma tutorial with the newly diagnosed. And as respiratory therapists like Rick and Steve often point out in the comments, regular medical professionals who don’t specialize in respiratory often don’t have comprehensive asthma knowledge. But, honestly, when AG was diagnosed I would have appreciated just a little nudge in the right direction:
Hey, you really should read up on asthma because it can get kind of serious. Go read some medical websites and then schedule an appointment with me if you have any questions.
Right?
Instead, too often it’s people like little old non-medical-professional me saying,
1. This is asthma. Take it seriously.
2. Read as much as you can. Here are some good websites in the sidebar.
My point?
If we’re all sharing information on blogs and messageboards, anyway, why shouldn’t the medical community use this resource in a clinical setting? I’d love to be an asthma educator, and I think (hope) I’d be good at it. The thing is, I know so many asthma parents and patients who’d be good at it, too.
(In other, sort-of related news, if you’re following CNN’s Empowered Patient series, today’s installment is “What to expect from your doctor.”)
I wonder what the result of that study would have been if RTs were doing the inhaler instruct. Or do they not have RTs in the UK?
Good point, and good question. I have no idea if they do, but I’m guessing they used nurses in the study b/c the appointments took place in a primary care setting, rather than a specialized clinic or hospital. I know I’ve never encountered an RT in a regular dr.’s office (sure wish I had, lol).
I’m not saying anything negative about nurses, after all my daughter is in nursing school. But I have not had great experiences with nurses, asthmawise… One nurse at the hospital told me she thought my low breathing scores were due to anxiety and if I just relaxed, I’d breath better in no time.
The nurse at the pulmo’s office where I had my allergy tests was the only medical professional to ever demonstrate how to use an inhalor, and that was after I’d had asthma for over a year.
I’ve never seen a RT but I imagine they would be outstanding in educating asthma patients. Likewise, Amy, I think you’d be a dandy educator!
Oh, that’s bad…..really, really bad. We’ve been lucky, but when I wrote nurses can “make or break” a hospital experience, believe me–we’ve encountered some bad ones. Just not very often. Once, I had an ER nurse tell me over the phone,
“Well, the nebulizer isn’t going to stop your daughter’s cough.”
It’s been my experience that I learn so much from “regular” people who are actually dealing with the major health issues I’ve had to deal with. I’ve been lucky to have (for the most part) excellent doctors, nurses, etc. But talking to someone who has been, or is, “there” makes such a difference. I find that both internet and IRL (in real life) friends can contribute so much to the quality of life for me & my family, and I am very happy to feel I can help others too!
I am so thankful, Amy, for this site
And as an example, here’s a question that has been worrying me – I know I need to start washing DS’s stuffed animals, especially the ones he sleeps with. I searched your site for “stuffed animals” to see if you had already done up a post about how to do this, but I didn’t find it. Is there a link you’d recommend, or could I persuade you to put this somewhere as a “how-to”?
I know it seems like something I shoudl just figure out on my own – but I haven’t done it for the past few months because it seems just that extra bit difficult. I think they need to go in the freezer, is that before or after washing? You know, that kind of thing.
Thanks!
Andie
Hi Andie, I’d be happy to.
And thanks for the suggestion–I’ll put it up tomorrow.