Family Education Reduces Costly ED Trips for Children with Asthma

HealthLeaders Media Staff, May 27, 2009

Better efforts to teach children and their parents about controlling asthma can greatly reduce pediatric emergency room visits, according to an analysis published today of 38 asthma intervention studies involving 7,843 children around the world.

Asthma is the leading cause of childhood admission to a hospital and is the most common chronic pediatric illness, affecting one in five children in the U.S., says the Asthma and Allergy Foundation of America. American children with asthma spend nearly 8 million days per year restricted to bed.

But educational interventions from health providers, such as physicians, nurses, and trained health educators, can teach parents and their children the importance of complying with preventive treatment plans, according to the Cochrane Collaboration, which produced this new report.

Education techniques reduced subsequent emergency room visits by 25% and resulted in fewer unscheduled trips to the doctor.

Strategies include teaching families how to better monitor breathing, utilize controlling versus rescue medications, use the right drugs early during an asthma attack and seek local medical assistance only if a patient’s condition was not improving, the studies demonstrate.

"Although educational programmes for children with asthma have been in use for decades, many hospitals do not have a routine approach for the education of children and their families about appropriate asthma management," the authors wrote. "One reason for this could be the lack of a systematic evaluation of the evidence base in this area, since the results of single studies have not consistently demonstrated reduced asthma morbidity or hospital re-attendances following education."

The Cochrane Collaboration is an international non-profit group that promotes the systematic search for evidence-based health solutions. The group's report is the second major evaluation of studies showing that education can prevent emergency visits. But previous studies were done in adults. This is the first collective evaluation of whether education can also work in a pediatric population.

The researchers could not single out any education techniques that were superior to others. Nor could they say whether interventions that lasted longer or were more intense than other efforts were more effective. But they concluded that one important tool was to educate parents about potential triggers in the home, such as smoking.

Although the number of subsequent emergency room visits made by the child was the primary endpoint analyzed, secondary outcomes measured included hospital admissions, unscheduled doctor visits, lung function tests, quality of life and functional health status, and the number of days a child stayed home ill.

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