Impact of a small-group educational intervention for 4-to 12-year-old asthmatic children and their parents on the number of healthcare visits and quality of life

Introduction. Asthma is the most frequent chronic disease in children. Many educational approaches to asthma exist, but there is no evidence of their effectiveness because of the heterogeneity of practices. Several studies show that good knowledge of the disease associated with personal skills and optimal. medication improve treatment compliance and decrease school absenteism and asthma exacerbations. The "Asthma School" conducted in the Children's Hospital of Lausanne, Switzerland is in keeping with these recommendations. The aim of the study was to evaluate the impact of Asthma School (therapeutic education) on the number of medical visits in asthmatic children. We also assessed the quality of life of children and their caregivers. Methods. We included in a prospective longitudinal study every child aged 4 to 12 years and their parents attending Asthma School over 1 year and followed them at 6 months. The number of emergency visits, medical appointments, and hospitalizations during the year before and after Asthma School was assessed with a questionnaire administered to the family physicians (GPs, pediatricians). Quality of life was evaluated with the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) at inclusion and 6 months after. Results. Twenty-seven children and their parents were included. The mean age was 7.02 years. Pediatric visits, emergency visits, and hospitalizations decreased significantly between the year before and the year after Asthma School. Emergency visits were 41, 1 year before Asthma School and 21, 1 year after it, medical appointments were 62 vs 30, and hospitalizations were 17 vs 2, respectively. The Wilcoxon sign-rank test demonstrates a significant difference with P = 0.010 for medical appointments, P = 0.021 for emergency visits, and P = 0.002 for hospitalizations. Quality of life in children improved in all domains but one evaluated by the PAQLQ(S) (score of 5.90 vs 6.52). Parental quality of life (PACQLQ) improved in all domains (overall score of 5.21 vs 6.15). Conclusion. Interactive education on asthma improves clinically important outcomes and quality of life in children and their families. The skills acquired allow them to manage daily life. (C) 2013 Elsevier Masson SAS. All rights reserved.