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In a recent systematic review on behalf of the Cochrane collaboration, Gibson et al found that interventions that consisted of education only did not bring about improvements in morbidity indexes. Conversely, interventions in which education was combined with self-monitoring and/or regular medical review and/or a written action plan improved a variety of health outcomes. Thus, asthma education should not be provided in isolation but as part of an integrated program of good quality care. Determination of the effects of specific components of educational programs has proved difficult. Self-management knowledge versus behaviour: No matter how successful the educational strategy, the acquisition of practical asthma knowledge is not sufficient to ensure satisfactory self-management behaviour : “To know is not to do”. In a cohort of patients admitted to hospital with severe acute asthma, Kolbe et al found that the score for self-management knowledge consistently exceeded the score for self-management of the same situation during an actual attack (behaviour). In other words, even when patients had a reasonable idea of what to do in an acute attack (and only 44% were judged to have such satisfactory knowledge), they were less likely to put those strategies into practice when faced with the real life situation. Of greater concern, the discrepancies were greatest for the strategies most likely to successfully abort an impending attack or be potentially life saving.