Education of healthcare professionals: a vital step in implementing new practices 

In 1994, the primary responsibility for providing asthma care in Finland rested with specialists. Due to the increasing number of patients, it became necessary to reevaluate this arrangement and shift the main responsibility to primary healthcare. Consequently, the primary healthcare personnel needed to be trained in asthma diagnostics and treatment.  

The task of educating all healthcare units across the country presented a significant challenge, given the limited resources available. The Asthma and Allergy Programmes were run by a non-governmental organisation, the Finnish Lung Health Association (Filha). The Asthma programme directly employed only one pulmonologist, while the Allergy Programme employed one pulmonologist and one nurse. (1,2)

Building local networks and training new practices

In the Asthma Programme, education was implemented in a stepwise manner. Initially, half-day educational sessions were targeted to pulmonary and paediatric hospital units. These specialists were then tasked with local coordination, including updating regional guidelines, referral practices, and organising local education initiatives. A key strategy involved training at least one physician and nurse in each Finnish municipal healthcare centre to serve as local asthma coordinators. In total, over 23,000 healthcare professionals participated in the educational sessions related to the Asthma Programme. (1) 

Professor Tuula Vasankari highlighted that it was a new thing in the 1990s to have all healthcare levels – specialists, GPs, nurses, and pharmacists – participating in the educational sessions together in one lecture hall. This collaboration served as a basis for building local asthma treatment networks. The new practices were successfully incorporated in the everyday work of the healthcare personnel. The primary care physicians welcomed the opportunity to diagnose and treat patients directly, rather than relying solely on specialist referrals. Small changes, such as training primary care staff to perform spirometry and PEF follow up, made a notable impact. 

The education was also spread throughout the country during the Finnish Allergy Programme. Tuula Vasankari explained how most of the education was carried out by two very dedicated people: 

“One doctor and one nurse basically drove around the country and held numerous educational sessions in healthcare centres – for a period of 10 years! Nowadays, I think no one would undertake such an endeavour, but luckily, modern remote meeting and e-learning platforms provide much easier opportunities for such trainings.” 

Revealing the impact of educational campaigns  

By the year 2000, the knowledge and competency in asthma care had increased a great deal in Finnish healthcare centres (Figure 1). The Asthma Programme was well accepted, as indicated by a survey in 1998 showing that 90% of chief physicians had made changes in asthma practices in their units. Rather than referring patients to specialists, the primary care physicians did over two-thirds of the diagnoses. The specialists mainly treated patients with severe asthma, and the patients stayed in specialist care for a shorter period. The role of pharmacists was also strengthened. During the programme, the pharmacists began offering patients written or verbal guidance on preventers and relievers, as well as providing instructions on inhaler usage. (1) 

While the Finnish Asthma Programme served as a basis for other national programmes in Europe, (3) it is also possible to launch such campaigns and drive change at a local level. At a minimum, it only requires one dedicated person to be the ambassador and educate others in their own units. 

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​​​​​Figure 1. Major changes in asthma care during the Finnish Asthma Programme. (1)