Design and setting: Randomised controlled trial in a primary health care setting on Thursday Island and Horn Island, and in Bamaga, Torres Strait region of northern Australia, April 2005 to March 2007.
Interventions: Children were randomly allocated to: (i) three additional asthma education sessions with a trained IHCW, or (ii) no additional asthma education. Both groups were re-assessed at 12 months.
Main outcome measures: Primary endpoint: number of unscheduled visits to hospital or a doctor caused by asthma exacerbation. Secondary outcomes: measures of quality of life (QoL) and functional severity index; asthma knowledge and understanding of asthma action plans (AAPs); and school days missed because of wheezing.
Results: The groups were comparable at baseline (except for asthma severity, which was adjusted for in the analysis). There were no significant differences in the primary outcome (number of unscheduled medical visits for asthma). School children in the intervention group missed fewer school days because of wheezing (100% < 7 days v 21% of those in the control group missed 7–14 days). Significantly more carers in the intervention group could answer questions about asthma medication, knew where their AAP was kept (84% v 56%), and were able to describe the plan (67% v 40%). In both the intervention and control groups (before-and-after comparison), there was a significantly reduced frequency of asthma exacerbations, as well as an improved QoL score and functional severity index, with no significant differences between the groups.
- 1. Mannino DM, Homa DM, Akinbami LJ, et al. Surveillance for asthma — United States, 1980–1999. MMWR Surveill Summ 2002; 51: 1-13.
- 2. Anderson HR, Gupta R, Strachan DP, Limb ES. 50 years of asthma: UK trends from 1955 to 2004. Thorax 2007; 62: 85-90.
- 3. Australian Centre for Asthma Monitoring. Asthma in Australia 2008. Canberra: Australian Institute of Health and Welfare, 2008. (AIHW Asthma Series No. 3, Cat. No. ACM 6.)
- 4. British guideline on the management of asthma: a national clinical guideline. Edinburgh: Scottish Intercollegiate Guidelines Network, 2008.
- 5. Global Initiative for Asthma. Global strategy for asthma management and prevention 2008 (update). 2008. http://www.ginasthma.org (accessed Apr 2010).
- 6. Gibson PG, Powell H, Coughlan J, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev 2003; (1): CD001117.
- 7. Evans D, Clark NM, Feldman CH, et al. A school health education program for children with asthma aged 8-11 years. Health Educ Q 1987; 14: 267-279.
- 8. Brown JV, Bakeman R, Celano MP, et al. Home-based asthma education of young low-income children and their families. J Pediatr Psychol 2002; 27: 677-688.
- 9. Bailey EJ, Cates CJ, Kruske SG, et al. Culture-specific programs for children and adults from minority groups who have asthma. Cochrane Database Syst Rev 2009; (2): CD006580.
- 10. Ratima M, Fox C, Fox B, et al. Long-term benefits for Maori of an asthma self-management program in a Maori community which takes a partnership approach. Aust N Z J Public Health 1999; 23: 601-605.
- 11. Chang A, Shannon C, O’Neil M, et al. Asthma management in indigenous children of a remote community using an indigenous health model. J Paediatr Child Health 2000; 36: 249-251.
- 12. Valery P, Chang A, Shibasaki S, et al. High prevalence of asthma in five remote indigenous communities in Australia. Eur Respir J 2001; 17: 1089-1096.
- 13. Hibbert ME, Lannigan A, Landau LI, Phelan PD. Lung function values from a longitudinal study of healthy children and adolescents. Pediatr Pulmonol 1989; 7: 101-109.
- 14. Phelan PD, Olinsky A, Oswald H. Asthma: classification, clinical patterns and natural history. In: Phelan PD, ed. Clinical paediatrics. Vol. 3. London: Bailliere Tindall, 1995: 307-318.
- 15. Juniper EF, Guyatt GH, Feeny DH, et al. Measuring quality of life in children with asthma. Qual Life Res 1996; 5: 35-46.
- 16. Juniper EF, Guyatt GH, Feeny DH, et al. Measuring quality of life in the parents of children with asthma. Qual Life Res 1996; 5: 27-34.
- 17. Rosier M, Bishop J, Nolan T, et al. Measurement of functional severity of asthma in children. Am J Respir Crit Care Med 1994; 149: 1434-1441.
- 18. Moudgil H, Marshall T, Honeybourne D. Asthma education and quality of life in the community: a randomised controlled study to evaluate the impact on white European and Indian subcontinent ethnic groups from socioeconomically deprived areas in Birmingham, UK. Thorax 2000; 55: 177-183.
- 19. Blixen CE, Hammel JP, Murphy D, Ault V. Feasibility of a nurse-run asthma education program for urban African-Americans: a pilot study. J Asthma 2001; 38: 23-32.
- 20. D’Souza W, Crane J, Burgess C, et al. Community-based asthma care: trial of a “credit card” asthma self-management plan. Eur Respir J 1994; 7: 1260-1265.
- 21. Juniper EF, Guyatt GH, Willan A, Griffith LE. Determining a minimal important change in a disease-specific Quality of Life Questionnaire. J Clin Epidemiol 1994; 47: 81-87.
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