Do asthma education programs decrease health care use in children?
This systematic review includes a paucity of high-quality studies, but it appears that children’s and parents/guardians' participation in asthma education programs is associated with fewer hospitalizations, emergency department visits, and office visits.
Plan de l'etude:
Self-funded or unfunded
These authors searched 3 databases to identify longitudinal studies of asthma education programs that reported the frequency of hospitalizations, emergency department visits, urgent care visits, and office visits in children. The authors ultimately included 15 studies (N = 925 children), 2 of which were randomized trials. Overall, the studies were of middling to poor quality. Participation in an education program was associated with fewer hospitalizations (relative risk [RR] 0.46; 95% CI 0.32 - 0.66), fewer emergency department visits (RR 0.69; 0.59 - 0.81), and fewer office visits (RR 0.79; 0.67 - 0.97). When the parents were involved, the reductions in hospitalizations (RR 0.38; 0.24 - 0.59) and emergency department visits (RR 0.69; 0.57 - 0.83) were even greater. The authors report high levels of heterogeneity among the data. We don’t know much about the participants' asthma severity, health literacy, and so forth. I suspect that the relatively large effect sizes mean the participants had more severe asthma and likely had more frequent healthcare use before enrollment.
Henry C. Barry, MD, MS
Michigan State University
East Lansing, MI