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J Asthma. 2016 Nov;53(9):955-63. doi: 10.3109/02770903.2016.1170140. Epub 2016 Apr 26.

The integrated care of asthma in Switzerland (INCAS)-study: Patients' perspective of received asthma care and their interest in asthma education.

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a Medical University Clinic, Cantonal Hospital Baselland , Liestal , Switzerland.
b Faculty of Medicine, University of Zurich , Switzerland.
c Department of Pharmaceutical Sciences , University of Basel , Switzerland.
d Center for Primary Health Care, University of Basel , Switzerland.
e Faculty of Medicine, University of Basel , Switzerland.
f Institute of Primary Care, University of Zurich , Switzerland.



For successful long-term asthma care, self-management education is a cornerstone. Little is known about associations between patients' interest in education, asthma control and care delivery. We compared patients' characteristics, asthma control and patients' perspective about asthma care in subjects with and without interest in asthma education. Moreover, we assessed reasons, why patients denied participating in asthma education.


Baseline data of 223 patients with asthma (age 43 ± 12 years, 38% male, 58% non-smokers, 13% current smokers), who participated in a multicentre longitudinal controlled study, are reported. At baseline, patients completed the Asthma Control Test (ACT), the Patient Assessment Chronic Illness Care questionnaire (PACIC 5A) and stated their interest in an asthma education programme.


Overall, 34% of all participants showed uncontrolled asthma. One hundred and twenty-five (56%) patients were interested in education. Compared to patients without interest, they were characterised by male gender (p = 0.013), worse asthma control (p < 0.001), and perception of lower quality of chronic asthma care delivery, in particular lower self-management support (p < 0.001). Main reasons for rejecting asthma education were having sufficient asthma knowledge, having only mild asthma, receiving adequate medical support and lack of time.


More than half of the patients were interested in asthma education. Interest was associated with worse asthma control and lower receipt of care according to the Chronic Care Model. Considering these aspects, this approach may help to improve care quality and allow targeting interventions to those patients who are interested in becoming active participants in their care and who might benefit most.


5A-approach; Asthma control; chronic care model; education programme; self-management

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