Asthma self-management programmes in a population of Italian children: a multicentric study. Italian Study Group on Asthma Self-Management Programmes

Abstract

This study was designed to answer three main questions: 1) Does asthma self-management education reduce asthma morbidity? 2) Are the two programmes "Living With Asthma" and "Open Airways" equally effective in doing so? 3) Is a shortened version of these programmes (4 weeks) as effective as the longer original programme (8 weeks)?Twelve Italian centres of paediatric bronchopneumology selected 312 children with asthma, who were stratified by disease severity, gender and age, and then randomly assigned to an Experimental group which received an educational programme or to a Comparison group, which did not. Of the 312 children selected, 209 (114 Experimental and 95 Comparison) completed the educational protocol and a 1 year follow-up.Data recorded during the last 2 months of follow-up, 10 months after the educational intervention, showed that the Experimental group required significantly fewer emergency treatments: this reduction was more evident in the more severe asthma cases. In the Experimental, but not in the Comparison group, patients with more severe asthma consumed more medications than patients with milder asthma. "Open Airways" yielded, in some cases, better results than "Living with Asthma": but a type 2 error is possible. The standard and the shortened programmes proved equally effective.In conclusion, following education, regardless of receiving a short or long educational programme, asthma patients use emergency care services less and use medications more appropriately in comparison with standard care without education. This suggests that short educational programmes can be highly cost-effective in children with asthma.

Small-group, interactive education and the effect on asthma control by children and their families

“…Post-education outcomes that have been identified by researchers include reductions in the numbers of visits to emergency departments, admissions to hospitals and unscheduled visits to physicians, and in costs related to health care. 8,10,26,[44][45][46][47] From 2005 onward, an increasing number of randomized control trials have been performed. [48][49][50][51][52][53][54][55] Some have focused on schools with children as the target learners [50][51][52] or included a multifaceted approach with education as one component.…”

Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey

“…Asthma was classified as mild, moderate, or severe according to a score derived from Ronchetti et al15 and based on the forced expiratory volume in one second (mild >80%, moderate 70-80%, severe <70% predicted), the number of asthma attacks in the past 12 months (2, 3-6, >6), the number of admissions to hospital for breathing problems in the past 12 months (0, 1-2, >2), and whether inhaled or oral corticosteroids had been taken in the past 12 month. Each of the first three variables had three levels of increasing severity (scored 1, 2, 3) and the fourth variable had two levels (scored 1 or 2).…”

Asthma: prevalence and cost of illness

“…However, of these only ,36% participated in a structured asthma education and only 23% received an evidence-based treatment regimen. To explain this fact, besides the change in diagnostic procedures and the rising prevalence and severity of the disease, quality deficits in the care of asthma patients and great regional variations in therapy are increasingly cited [15][16][17][18][19][20][21].…”