Parental education and guided self-management of asthma and wheezing in the pre-school child: a randomised controlled trial

Stevens, C. A.; Wesseldine, L. J.; Couriel, J. M.; Dyer, A. J.; Osman, L. M.; Silverman, M.
January 2002
Thorax;Jan2002, Vol. 57 Issue 1, p39
Academic Journal
Background: The effects on morbidity were examined of providing an educational intervention and a written guided self-management plan to the parents of pre-school children following a recent attendance at hospital for asthma or wheeze. Methods: A prospective, randomised, partially blinded, controlled trial was designed at two secondary care centres. Over a 1 3 month period 200 children aged 1 8 months to 5 years at the time of admission to a children's ward or attendance at an accident and emergency department or children's (emergency) assessment unit (A&E/CAU) with a primary diagnosis of acute severe asthma or wheezing were recruited. 10] children were randomised into the control group and received usual care and 99 were assigned to the intervention group and received: (1) a pre-school asthma booklet; (2) a written guided self-management plan; and (3) two 20 minute structured educational sessions between a specialist respiratory nurse and the parent(s) and child. Subjects were assessed at 3, 6, and 12 months. The main outcomes were GP consultation rates, hospital re-admissions, and attendances at A&E/CAU Secondary outcomes included disability score, caregivers' quality of life, and parental knowledge of asthma. Results: There were no statistically significant differences between the two groups during the 12 month follow up period for any of the main or secondary outcome measures. Conclusions: These results do not support the hypothesis that the introduction of an educational pack- age and a written guided self-management plan to the parents of pre-school children with asthma who had recently attended hospital for troublesome asthma or wheeze reduces morbidity over the subsequent 12 months.


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