***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : No r and omised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists . Most r and omised trials of asthma self-management have recruited participants from secondary care ; there is uncertainty regarding its effectiveness in primary care . A r and omised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at a community pharmacy . Methods : Twenty four adults attending a community pharmacy in Tower Hamlets , east London for routine asthma medication were r and omised into two groups : the intervention group received self-management advice from the pharmacist with weekly telephone follow up for 3 months and the control group received no input from the pharmacist . Participants self-completed the North of Engl and asthma symptom scale at baseline and 3 months later . Results : The groups were well matched at baseline for demographic characteristics and mean ( SD ) symptom scores ( 26.3 ( 4.8 ) and 27.8 ( 3.7 ) in the intervention and control groups , respectively ) . Symptom scores improved in the intervention group and marginally worsened in the control group to 20.3 ( 4.2 ) and 28.1 ( 3.5 ) , respectively ( p<0.001 ; difference adjusted for baseline scores = 7.0 ( 95 % CI 4.4 to 9.5 ) . Conclusions : A self-management programme delivered by a community pharmacist can improve asthma control in individuals recruited at a community pharmacy . Further studies should attempt to confirm these findings using larger sample s and a wider range of outcome measures Background Asthma is a prevalent and costly disease result ing in reduced quality of life for a large proportion of individuals . Effective patient self-management is critical for improving health outcomes . However , key aspects of self-management such as self-monitoring of behaviours and symptoms , coupled with regular feedback from the health care team , are rarely addressed or integrated into ongoing care . Health information technology ( HIT ) provides unique opportunities to facilitate this by providing a means for two way communication and exchange of information between the patient and care team , and access to their health information , presented in personalized ways that can alert them when there is a need for action . The objective of this study is to evaluate the acceptability and efficacy of using a web-based self-management system , My Asthma Portal ( MAP ) , linked to a case-management system on asthma control , and asthma health-related quality of life . Methods The trial is a parallel multi-centered 2-arm pilot r and omized controlled trial . Participants are r and omly assigned to one of two conditions : a ) MAP and usual care ; or b )  usual care alone .  Individuals will be included if they are between 18 and 70 , have a confirmed asthma diagnosis , and their asthma is classified as not well controlled by their physician .  Asthma control will be evaluated by calculating the amount of fast acting beta agonists recorded as dispensed in the provincial drug data base , and asthma quality of life using the Mini Asthma Related Quality of Life Question naire . Power calculations indicated a needed total sample size of 80 subjects . Data are collected at baseline , 3 , 6 , and 9 months post r and omization . Recruitment started in March 2010 and the inclusion of patients in the trial in June 2010 . Discussion Self-management support from the care team is critical for improving chronic disease outcomes . Given the high volume of patients and time constraints during clinical visits , primary care physicians have limited time to teach and reinforce use of proven self-management strategies . HIT has the potential to provide clinicians and a large number of patients with tools to support health behaviour change . Trial Registration Current Controlled Trials IS RCT N34326236 BACKGROUND Whether asthma morbidity in minority groups can be reduced by preventative health care measures delivered in the relevant ethnic dialects requires further evaluation . This study reports clinical outcomes and quality of life from a community based project investigating white European ( W/E ) and Indian subcontinent ( ISC ) ethnic groups with asthma living in deprived inner city areas of Birmingham , UK . METHODS Six hundred and eighty nine asthmatic subjects ( 345 W/E , 344 ISC ) of mean ( SD ) age 34.5 ( 15 ) years ( range 11–59 ) and mean forced expiratory volume in one second ( FEV1 ) of 80 % predicted were interviewed in English , Punjabi , Hindi , or Urdu . Subjects r and omised to the active limb of a prospect i ve , open , r and omised , controlled , parallel group , 12 month follow up study underwent individually based asthma education and optimisation of drug therapy with four monthly follow up ( active intervention ) . Control groups were seen only at the beginning and end of the study . Urgent or emergency interactions with primary and secondary health care ( clinical outcomes ) and both cross sectional and longitudinal data from an Asthma Quality of Life Question naire ( AQLQ ) were analysed . RESULTS Clinical outcomes were available for 593 subjects . Fewer of the active intervention group consulted their GP ( 41.8 % versus 57.8 % , odds ratio ( OR ) 0.52 ( 95 % CI 0.37 to 0.74 ) ) or were prescribed antibiotics ( 34.9 % versus 51.2 % , OR 0.51 ( 95 % CI 0.36 to 0.72 ) ) , but by ethnicity statistically significant changes occurred only in the W/E group with fewer also attending A&E departments and requiring urgent home visits . Active intervention reduced the number of hospital admissions ( 10 versus 30 ) , GP consultations ( 341 versus 476 ) , prescriptions of rescue oral steroids ( 92 versus 177 ) , and antibiotics ( 220 versus 340 ) , but again significant improvements by ethnicity only occurred in the active W/E group . AQLQ scores were negatively skewed to the higher values ; regression analysis showed that lower values were associated with ISC ethnicity . Longitudinal changes ( for 522 subjects ) in the mean AQLQ scores were small but statistically significant for both ethnic groups , with scores improving in the active and worsening in the control groups . CONCLUSIONS Active intervention only improved clinical outcomes in the W/E group . AQLQ scores , although lower in the ISC group , were improved by active intervention in both ethnic groups OBJECTIVE To report the results of a 2-year pilot program of asthma education based on National Heart , Lung , and Blood Institute treatment guidelines . PATIENTS AND METHODS Asthmatic members ( n = 6698 ) of a managed care organization received education about their condition directly or through their primary care physician . Medical and pharmacy administrative cl aims data were review ed to measure acute asthma events and prescribed therapies in the first ( the baseline ) and second years of the study . The cl aims data were augmented by member surveys from a stratified r and om sample of 2734 asthmatic patients who were members ( 6 years of age or older ) in the baseline year . RESULTS Compared with the first year , asthmatic members received fewer inpatient services and the proportion of asthmatic members prescribed oral inhaled corticosteroids increased 30 % in the second year . Health-related quality of life , measured with vali date d general and disease-specific instruments ; satisfaction with the quality of care ; exposure to patient education ; knowledge of the disease ; and member 's confidence in their ability to manage their disease showed statistically significant improvements during the follow-up year of the program for both adult and child asthmatic members . CONCLUSION For asthmatic members of this health plan , a comprehensive asthma health management program improved processes of care and outcomes Background Many studies have shown the effectiveness of self-management for patients with asthma . In particular , possession and use of a written asthma action plan provided by a doctor has shown to significantly improve patients ’ asthma control . Yet , uptake of a written asthma action plan and preventative asthma management is low in the community , especially amongst adults . Objective A Web-based personally controlled health management system ( PCHMS ) called Healthy.me will be evaluated in a 2010 CONSORT-compliant 2-group ( static websites verse PCHMS ) parallel r and omized controlled trial ( RCT ) ( allocation ratio 1:1 ) . Methods The PCHMS integrates an untethered personal health record with consumer care pathways and social forums . After eligibility assessment , a sample of 300 adult patients with moderate persistent asthma will be r and omly assigned to one of these arms . After 12 months of using either Healthy.me or information websites ( usual care arm ) , a post- study assessment will be conducted . Results The primary outcome measure is possession of or revision of an asthma action plan during the study . Secondary outcome measures include : ( 1 ) adherence to the asthma action plan , ( 2 ) rate of planned and unplanned visits to healthcare providers for asthma issues , ( 3 ) usage patterns of Healthy.me and attrition rates , ( 4 ) asthma control and asthma exacerbation scores , and ( 5 ) impact of asthma on life and competing dem and s , and days lost from work . Conclusions This RCT will provide insights into whether access to an online PCHMS will improve uptake of a written asthma action plan and preventative asthma actions . Trial Registration Trial Registration : Australian New Zeal and Clinical Trials Registry ACTRN12612000716864 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?id=362714 ( Archived by WebCite at http://www.webcitation.org/6IYBJGRnW ) Abstract Objectives : To evaluate the effectiveness of an asthma re source centre in improving treatment and quality of life for asthmatic patients Design : Community based r and omised controlled trial Setting : 41 general practice s in Greenwich with a practice nurse Subjects : All registered patients aged 15 - 50 years Intervention : Nurse specialists in asthma who educated and supported practice nurses , who in turn educated patients in the management of asthma according to the British Thoracic Society 's guidelines Main outcome measures : Quality of life of  asthmatic patients , attendance at accident and emergency departments , admissions to local hospitals , and steroid prescribing by general practitioners Results : Of 24 400 patients r and omly selected and surveyed in 1993 , 12 238 replied ; 1621 were asthmatic of whom 1291 were sent a repeat question naire in 1996 and 780 replied . Of 24 400 patients newly surveyed in 1996 , 10 783 ( 1616 asthmatic ) replied . No evidence was found for an improvement in asthma related quality of life among newly surveyed patients in intervention practice s compared with control practice s. Neither was there evidence of an improvement in other measures of the quality of asthma care . Weak evidence was found for an improvement in quality of life in intervention practice s among asthmatics registered with study practice s in 1993 and followed up in 1996 . Neither attendances at accident and emergency departments nor admissions for asthma showed any tendency to diverge in intervention and control practice s over the study period . Steroid prescribing rates rose steadily during the study period . The average annual increase in steroid prescribing was 3 % per year higher in intervention than control practice s ( 95 % confidence interval −1 % to 6 % , P=0.10 ) Conclusions : This model of service delivery is not effective in improving the outcome of asthma in the community . Further development is required if cost effective management of asthma is to be A prospect i ve controlled trial of home monitoring of peak expiratory flow rate ( PEFR ) was conducted to determine the usefulness of an objective measure of lung function in association with an education program and a medication self-management plan in reducing morbidity in adult patients with asthma . Thirty-five patients managed themselves , using peak flow readings as the basis for the therapeutic plan coupled with educational intervention , whereas 35 control patients  used symptoms and spirometric data for following physicians ' treatment plans . After a 6-mo study period , patients in the experimental group showed statistically significant improvements in morbidity parameters ( days lost from work , acute asthma attacks , days on antibiotic therapy , physician consultations , and emergency room admissions for asthma ) , increases in FVC , FEV1 , and FEV1/FVC , mean PEFR and mean morning PEFR , decrease in percentage of the mean PEFR amplitude , and a reduction in the use of inhaled beta-agonists , oral theophylline , and oral prednisone .  Although improvements in some of these parameters were also found in the control group , they did not reach the levels of significance obtained in the experimental group . The personal use of an objective measure of lung function in association with a medication self-management plan leads to improvement in the patient 's condition OBJECTIVES Despite advances in recent years , asthma morbidity and mortality have been noted to be on the increase in the past decade . The present study examined the failures and recommendations of past studies and introduced a new milieu for asthma care -- the community pharmacy . The study incorporated a care protocol with the important ingredients of asthma education on medications , triggers , self-monitoring and an asthma plan , with pharmacists taking responsibility for outcomes , assessment of a patient 's readiness to change and tailoring education to that readiness , compliance monitoring and physician consultation to achieve asthma prescribing guidelines . METHODS Thirty-three pharmacists in British Columbia , specially trained and certified in asthma care , agreed to participate in a study in which experienced pharmacists would have asthma patients allocated to enhanced ( pharmaceutical ) care ( EC ) or usual care ( UC ) . Pharmacists less experienced were clustered by geography and had their pharmacies r and omized 
    Output:
    
There is moderate to low quality evidence that chronic disease management programmes for adults with asthma can improve asthma-specific quality of life , asthma severity , and lung function tests .
Overall , these results provide encouraging evidence of the potential effectiveness of these programmes in adults with asthma when compared with usual care .