Commentary: Self-management programs in the treatment of asthma.

demonstrated by outcome studies of asthma selfmanagement. The objective of asthma self-management is to train patients to avoid asthma and reduce attacks (Bailey, Davies, & Kohler, 1998). A combination of education and behavior control procedures may be used to arrive at this goal. Among other things, patients are taught: to manage an asthma attack; to identify their asthma triggers and to avoid them; to recognize the early warning signs of asthma and to use them as cues for initiation of attack management procedures; to take medication properly; and to minimize the consequences of asthma by avoiding or reducing interpersonal and other problems caused by asthma. Throughout asthma selfmanagement training, cues are introduced into the patient’s environment whose purpose is to prompt asthma management activities. The combination of education and behavior control helps the patient to avoid asthma and, if it occurs, to reduce it quickly and efficiently. By accomplishing these goals, selfmanagement leads to a lessening of inflammation. There is a need for asthma self-management in medicine, one that has been recognized. At a recent meeting of physicians who treat asthma, I was struck by the frequency with which they mentioned behavior problems relating to topics such as medication compliance and avoidance of allergens. To address these problems, self-management is now featured prominently in National Institutes of Health (e.g., National Heart, Lung, and Blood Institute, 1997) publications dealing with management of asthma. Its use in the practice of asthma control is increasing. And the long-range outlook for Journal of Pediatric Psychology, Vol. 24, No. 4, 1999, pp. 331–332