Effectiveness of pictorial based self-management among adult with asthma in a suburban primary care health clinic: a randomised controlled trial


M R Radzniwan 1, S Y Chow 1, A S Shamsul 3, M F Ali 4

1 Department of Family Medicine, Universiti Sains Islam Malaysia, 2 Klinik Kesihatan Jinjang, 3 Department of Community Health, UKM Medical Centre, and 4 Department of Family Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia



Introduction: Self-management asthma education is important in a good asthma model of care. However, its delivery should be simple and easily comprehensible for successful utilisation. Pictograms have been shown to assist the understanding of asthma self-management. The objective of this study is to determine the effectiveness of a pictorial based asthma self-management towards asthma control. Material and Methods: This was a non-blinded single centre randomised trial. Sixty-two adult asthmatics attending a primary care clinic in suburban Selangor, Malaysia and taking preventive inhaled corticosteroids were randomised into two groups; pictorial based self-management or conventional care. The pictorial based group received a ten minute individualised session on pictorial asthma action plan. The main outcome measures were improvement in asthma control test (ACT) scores, number of hospitalisations, unscheduled health care visits and absenteeism after three months of follow up. Results: A total of sixty-two participants were analysed. Both groups had improvement of asthma control within the follow-up period. However, there was no significant difference in the asthma control (ACT score changes) between the intervention and control group with their mean ACT score: 21.3 3.2 vs 20.5 3.8, p=0.4, respectively. The mean difference of ACT score from baseline were 2.2 3.2 vs 1.3 4.6 p=0.4, respectively. No significant statistical differences were observed in the number of unscheduled healthcare visits, hospitalisations and absenteeism among the two groups.  Conclusions: Pictorial based self-management did not offer any advantage over the conventional care among relatively well controlled asthma, middle to lower socioeconomic and low education background population.


Key words: Asthma, education, management, control, self-management


Correspondence author: Suet Yin CHOW, Klinik Kesihatan Jinjang, No. 2, Jalan Jinjang, Setia 3, Jinjang Utara Tambahan 52000, Kuala Lumpur, Malaysia. Email: chowsy82@gmail.com


Brunei Int Med J. 2016; 12 (6): 183-190