A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. Asthma education programmes improve patient knowledge, but their impact on health outcomes is less well established. This review of 25 trials was conducted to test whether four types of such programmes influence health outcomes. The 9 trials that showed the effect on hospital admissions are presented in Figure 1 with odds ratios for each program type. Though there was a significant overall reduction in hospital admissions in the intervention group (mean estimate to the left of the line of unity), this effect was confined to patients who received 'optimal' care in whom the odds of admissions were reduced by a third (OR=0.35). Here, 'Optimum' comprised self-monitoring, regular review and a written self-management plan.