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Interventions for educating children who have attended the emergency room for asthmaHaby MM, Waters E, Robertson CF, Gibson PG, Ducharme FM
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SummaryThere is no consistent evidence that education about asthma to children and/or their parents going to emergency departments prevents future problems, and more research is needed.Admission of children to hospital due to asthma is common and costly. This review looked at the evidence that hospital admissions could be prevented by giving effective education about asthma to children (and/or their parents) who attended the emergency department because of an acute attack of asthma. The studies showed no consistent pattern. Some showed evidence suggestive of a worthwhile effect, but others did not. Overall, there was no statistically significant evidence of benefit. More research is needed to assess the impact of asthma education on hospital visits and other important outcomes, such as quality of life.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
January 22. 2001 AbstractBackgroundAsthma is one of the most common reasons for paediatric admissions to hospital, with substantial cost to the community. There is some evidence to suggest that many hospital admissions could be prevented with effective education about asthma and its management. ObjectivesTo conduct a systematic review of the literature in order to identify whether asthma education leads to improved health outcomes in children who have attended the emergency department for asthma. Search strategyWe searched the Cochrane Airways Group trials register, including MEDLINE, EMBASE, and CINAHL databases, and reference lists of trials and review articles. Selection criteriaRandomised controlled trials or controlled clinical trials of asthma education for children who had attended the emergency department for asthma, with or without hospitalisation, within the previous 12 months. Data collection and analysisTwo reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Main resultsEight trials involving 1407 patients were included, in all the education was provided by nurses or researchers. Compared to control (usual care or lower intensity education) education did not reduce subsequent emergency department (ED) visits [4 trials; relative risk (RR)= 0.87, 95% confidence interval (CI) 0.37 to 2.08], hospital admissions [5 trials; RR=0.74, 95% CI 0.38 to 1.46] and unscheduled doctor visits [5 trials; RR= 0.74, 95% CI 0.49 to 1.12). Each analysis showed evidence of heterogeneity among the studies (P<0.01). Subgroup analyses by the overall difference in scale of intervention between treatment and control groups (comprehensive programme versus information only) or the timing of the intervention/recruitment (early versus delayed) gave similar results to the main analysis and still revealed significant heterogeneity between trials. Authors' conclusionsOn the basis of the published trials, there is no firm evidence to support the use of asthma education for children who have attended the emergency department for asthma as a means of reducing subsequent ED visits, hospital admissions or unscheduled doctor visits. Some trials appeared to show clear evidence of benefit, but reasons for differences between these and the negative studies is not clear. More research is required |