Role of "Asthma School" in Disease Management
Role of "Asthma School" in Disease Management
. According to the definition provided by the GINA guidelines, asthma is characterized by a
 variable and reversible limitation of expiratory airflow and by the following symptoms:
 wheezing, dyspnoea, thoracic constriction and/or cough. The type and the severity of airflow
 limitation can vary over time (1) depending on external agents, such as physical exercise,
 polluting agents, climate changes and viral infections. The therapy is mainly based on the
 use of inhaled corticosteroids and bronchodilators. Patients affected by severe asthma (~ 10%
 of total prevalence of asthma and at high risk of exacerbations and/or hospitalization) may
 not control their symptoms, even if exposed to maximal doses of inhalation therapy.The
 behavioural sciences can potentially help to find the psychological factors behind scarce
 adherence and to develop strategies with the aim of improving the interactive processes
 between patients, medical doctors and health care professionals
Asthma is a chronic inflammatory disease affecting 300 million people worldwide, especially
 children. In Italy, asthma affects 3 million patients and represents one of the main expenses
 of the Italian National Heath Care Service. According to the definition provided by the GINA
 guidelines, asthma is characterized by a variable and reversible limitation of expiratory
 airflow and by the following symptoms: wheezing, dyspnoea, thoracic constriction and/or
 cough. The type and the severity of airflow limitation can vary over time (1) depending on
 external agents, such as physical exercise, polluting agents, climate changes and viral
 infections. The therapy is mainly based on the use of inhaled corticosteroids and
 bronchodilators. Patients affected by severe asthma (~ 10% of total prevalence of asthma and
 at high risk of exacerbations and/or hospitalization) may not control their symptoms, even if
 exposed to maximal doses of inhalation therapy. More than one third of severe asthma patients
 receive oral corticosteroids prescriptions, with the risk of severe and irreversible adverse
 events. Therapy adherence is generally poor when therapeutic regimes are prescribed for
 chronic diseases, including asthma (4). The behavioural sciences can potentially help to find
 the psychological factors behind scarce adherence and to develop strategies with the aim of
 improving the interactive processes between patients, medical doctors and health care
 professionals (4). Several studies have described intervention models focused on education of
 the patients to symptoms and exacerbations recognition, therapy management, reduction of the
 exposure to trigger agents and improvement of social and physical activities (5-6). The
 intervention is not able to make patients independent in disease managing, but can improve
 the cooperation in asthma management. Another important aspect in asthma management is the
 quality of the therapeutic intervention: the correct delivery of inhalation therapy is the
 key for the disease control (3). Specific educational intervention such as "asthma school"
 can improve symptoms control and reduce; however, up to day, a universal and standardized
 protocol is not available and further studies are needed.
Inclusion Criteria:

 -  Asthma diagnosis according to GINA / ATS guidelines.

 -  Age ≥18 years

 Exclusion Criteria:

 •cognitive impairment