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Educational interventions improve outcomes for children with asthma

J Fam Pract. 2003 October;52(10):747-769
By
Caroline R. Richardson, MD
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  • BACKGROUND: A previously published meta-analysis suggested that asthma education programs for children do not affect asthma-related morbidity or use of health care resources. However, a number of new studies do show improved clinical outcomes resulting from such programs. This meta-analysis incorporates these more recent studies.
  • POPULATION STUDIED: This meta-analysis pooled results from 32 controlled clinical trials of asthma education interventions for children. Eligible trials enrolled a total of 3706 children with mild, moderate, or severe asthma who were aged 2 to 18 years.
  • STUDY DESIGN AND VALIDITY: For this quantitative meta-analysis, the authors conducted a systematic search for eligible controlled trials of asthma education interventions targeting children, employing both electronic and hand searches. While the interventions studied varied widely in intensity and focus, trials of simple information-only educational interventions were excluded.
  • OUTCOMES MEASURED: Eight different asthma-related outcomes were considered: lung function as measured by forced expiratory volume in 1 second (FEV1) or peak expiratory flow rate, number of days absent from school, number of days of restricted activity, number of disturbed nights, self-efficacy scales, symptom scores, number of visits to an emergency department, and hospitalizations.
  • RESULTS: This meta-analysis provides some evidence for a modest effect of asthma education interventions for children in particular. Lung function increased, with FEV1 increasing an average of 0.24 L and peak flow measures increasing an average of 9.5, though it did not consistently affect symptom scores. The number of days of restricted activity were moderately decreased (effect size, –0.29; 95% CI, –0.49 to –0.08).
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PRACTICE RECOMMENDATIONS

Asthma education interventions for children may result in modest improvement in a wide range of clinical outcomes. Interventions should target children with more severe asthma and teach them to use objective measures of lung function, such as peak flow for self-monitoring instead of symptombased self-monitoring.

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