CMAJ • September 1, 2009; 181 (5). First published August 17, 2009; doi:10.1503/cmaj.080947
© 2009 Canadian Medical Association or its licensors
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Research

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

Wade T.A. Watson, MD MEd, Cathy Gillespie, MN, Nicola Thomas, BN, Shauna E. Filuk, BN, Judy McColm, RN, Michelle P. Piwniuk, RRT and Allan B. Becker, MD

From the Children’s Asthma Education Centre (Watson, Gillespie, Thomas, Filuk, McColm, Piwniuk, Becker), Children’s Hospital of Winnipeg, Winnipeg, Man.; the Division of Allergy (Watson), Dalhousie University, IWK Health Centre, Halifax, NS; and the Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.

Correspondence to: Dr. Wade Watson, IWK Health Centre, 5850/5980 University Ave., PO Bvox 9700, Halifax NS B3K 6R8; fax 902 470-7308; wade.watson{at}iwk.nshealth.ca

Background: Effective approaches to education about asthma need to be identified. We evaluated the impact on asthma control by children and their caregivers of an intervention involving small-group, interactive education about asthma.

Methods: We randomly assigned children who visited an emergency department for an exacerbation of asthma (n = 398) to either of 2 groups. Children assigned to the control group followed the usual care recommended by their primary care physician. Those assigned to the intervention group participated in a small-group, interactive program of education about asthma. We examined changes in the number of visits to the emergency department during the year after the intervention.

Results: During the year after enrolment, children in the intervention group made significantly fewer visits to the emergency department (0.45 visits per child) compared with those in the control group (0.75 visits per child) (p = 0.004). The likelihood of a child in the intervention group requiring emergency care was reduced by 38% (relative risk [RR] 0.62, 95% confidence interval CI 0.48–0.81, p = 0.004). Fewer courses of oral corticosteroids (0.63 per child) were required by children in the intervention group than by those in the control group (0.85 per child) (p = 0.006). We observed significant improvements in the symptom domain of the questionnaire on pediatric asthma quality-of-life (p = 0.03) and the activity domain of the questionnaire on caregivers’ quality of life (p = 0.05). Parents of children in the intervention group missed less work because of their child’s asthma after participating in the educational program (p = 0.04). No impact on hospital admissions was observed.

Interpretation: Education about asthma, especially in a small-group, interactive format, improved clinically important outcomes and overall care of children with asthma.


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Highlights
Can. Med. Assoc. J. 2009 181: 237. [Full Text] [PDF]

Dans ce numéro
Can. Med. Assoc. J. 2009 181: E70. [Full Text] [PDF]