@article {D{\textquoteright}Souza464, author = {WJ D{\textquoteright}Souza and T Slater and C Fox and B Fox and H Te Karu and T Gemmell and MM Ratima and NE Pearce and RB Beasley}, title = {Asthma morbidity 6 yrs after an effective asthma self-management programme in a Maori community}, volume = {15}, number = {3}, pages = {464--469}, year = {2000}, doi = {10.1034/j.1399-3003.2000.15.07.x}, publisher = {European Respiratory Society}, abstract = {A 6-month Maori community-based asthma self-management programme, involving a "credit card" asthma self-management plan, has previously been shown to be an effective and acceptable system for reducing asthma morbidity. The effectiveness of the asthma self-management programme and participants{\textquoteright} self-management behaviour was assessed 6 yrs after the formal end of the programme. Participants were surveyed at the time of enrollment, and 1, 2, and 6 yrs after completing the programme. In each survey, participants were questioned on markers of asthma morbidity and use of medical services during the previous 12 months. Self-management behaviour was assessed using a questionnaire at 2 years and 6 yrs. Of the 69 original participants, 47 (68\%) were surveyed after 6 yrs. They generally had reduced severe asthma morbidity and emergency use of health services from baseline. In particular, the proportion who had an emergency visit to a general practitioner had decreased from 41\% to 18\% (p=0.02). However, the percentage of nights woken due to asthma had returned to preintervention levels, and the proportion of participants taking prescribed regular inhaled steroid had decreased from 91\% to 53\% (p\<0.001). Compared with 2 yrs after completion of the asthma programme, self-management behaviour had also deteriorated, with 29\% versus 73\% (p\<0.001) using their peak flow meter daily when their asthma was "getting bad" and 41\% versus 86\% (p\<0.001) using the "credit card" plan to increase the amount of inhaled steroids in the last year. Although the programme participants were still experiencing reduced morbidity from their asthma 6 yrs after the end of the self-management programme, the benefits were less than those observed at 2 yrs. These findings suggest that under-recognition and under-treatment of asthma with appropriate amounts of inhaled steroids is a major factor contributing to asthma morbidity in this indigenous rural community. To obtain enduring benefits from a self-management system of care continued reinforcement of self-management skills seems to be an essential component of any follow-up.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/15/3/464}, eprint = {https://erj.ersjournals.com/content/15/3/464.full.pdf}, journal = {European Respiratory Journal} }