Abstract
We aimed to evaluate a family-oriented psycho-educational asthma training program for the age group of 2–5 years, involving both parents and children. Children were included after having at least 3 obstructive episodes in their life plus chronic or recurrent wheeze in the 6 months before the start of the study. In the multicenter randomized trial we had (1) a waiting group (WG), (2) an instruction group (IG) trained in a structured way according to the national asthma guideline, and (3) an education group (EG), having a standardized multiprofessional psycho-educational program, according to the national licensed asthma education for the age group of 6–18 years. All were assessed after 6 months. A subgroup analysis was performed on those being on regular inhaled corticosteroids at study entry (74.3%). A total of 338 children were randomized, and 288 (85%) completed the study. In the asthma emergency management, test scores increased most in EG, less in IG, and not in WG. For emergency visits the risk ratio for EG was 0.68 compared to IG: Patients regularly inhaling corticosteroids (74.3%) had an increased risk for emergency visits when having only an instruction (OR 3.99 [1.89–8.40]) or had been waiting (OR 2.5 [1.16–5.37]) when compared to those having an asthma education. We conclude that in the German health system, the family oriented psycho-educational program provided in a standardized manner by a multiprofessional team is effective also in the age group of 2–5 years. It should be made accessible to each asthmatic child.
Similar content being viewed by others
References
Coffman JM, Cabana MD, Halpin HA, Yelin EH (2008) Effects of asthma education on children's use of acute care services: a meta-analysis. Pediatrics 121(3):575–586
Guevara JP, Wolf FM, Grum CM, Clark NM (2003) Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ 326:1308–1309
Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M (2009) Interventions for educating children who are at risk of asthma-related emergency department attendance. Cochrane Database Syst Rev:CD001290
Arbeitsgemeinschaft Asthmaschulung im Kindes- und Jugendalter e.V.; [Ed.] (2007) Handbuch Qualitätsmanagement in der Asthmaschulung von Kindern und Jugendlichen. Zuckschwerdt, 3rd ed, ISBN-13: 9783886039227
Szczepanski R, Gebert N, Hümmelink R, Könning J, Schmidt S, Runde B, Wahn U (1996) Outcome of structured asthma education in childhood and adolescence. Pneumologie 50:44–48
Scholtz W, Haubrock M, Lob-Corzilius T, Gebert N, Wahn U, Szczepanski R (1996) Cost-effectiveness studies of ambulatory educational programs for children with asthma and their families. Pneumologie 50:538–543
Oxford Centre for Evidence-based Medicine—Levels of Evidence (March 2009); http://www.cebm.net/index.aspx?o=1025 (04.01.2010)
Guilbert TW, Morgan WJ, Zeiger RS, Bacharier LB, Boehmer SJ, Krawiec M, Larsen G, Lemanske RF, Liu A, Mauger DT, Sorkness C, Szefler SJ, Strunk RC, Taussig LM, Martinez FD (2004) Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol 114:1282–1287
Morgan WJ, Stern DA, Sherrill DL, Guerra S, Holberg CJ, Guilbert TW, Taussig LM, Wright AL, Martinez FD (2005) Outcome of asthma and wheezing in the first 6 years of life: follow-up through adolescence. Am J Respir Crit Care Med 172:1253–1258
Becker A, Bérubé D, Chad Z, Dolovich M, Ducharme F, D'Urzo T, Ernst P, Ferguson A, Gillespie C, Kapur S, Kovesi T, Lyttle B, Mazer B, Montgomery M, Pedersen S, Pianosi P, Reisman JJ, Sears M, Simons E, Spier S, Thivierge R, Watson W, Zimmerman B, Canadian Network For Asthma Care; Canadian Thoracic Society (2005) Canadian Pediatric Asthma Consensus guidelines, 2003 (updated to December 2004): diagnosis of asthma. CMAJ 173(6 Suppl):S15–S19
Nationale Versorgungsleitlinie Asthma 2006 (http://www.versorgungsleitlinien.de/methodik/pdf/nvl_asthma_lang_1.5.pdf; approached 19.7.2009)
Rosier MJ, Bishop J, Nolan T, Robertson CF, Carlin JB, Phelan PD (1994) Measurement of functional severity of asthma in children. Am J Respir Crit Care Med 149:1434–1441
Keogh-Brown MR, Bachmann MO, Shepstone L, Hewitt C, Howe A, Ramsay CR, Song F, Miles JN, Torgerson DJ, Miles S, Elbourne D, Harvey I, Campbell MJ (2007) Contamination in trials of educational interventions. Health Technol Assess 11(43):iii, ix-107
Smith JR, Mugford M, Holland R, Candy B, Noble MJ, Harrison BD, Koutantji M, Upton C, Harvey I (2005) A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma. Health Technol Assess 9(23):iii–iv, 1–167
Butz AM, Tsoukleris MG, Donithan M, Hsu VD, Zuckerman I, Mudd KE, Thompson RE, Rand C, Bollinger ME (2006) Effectiveness of nebulizer use-targeted asthma education on underserved children with asthma. Arch Pediatr Adolesc Med 160(6):622–628
Stevens CA, Wesseldine LJ, Couriel JM, Dyer AJ, Osman LM, Silverman M (2002) Parental education and guided self-management of asthma and wheezing in the pre-school child: a randomised controlled trial. Thorax 57(1):39–44
Greineder DK, Loane KC, Parks P (1999) A randomized controlled trial of a pediatric asthma outreach program. J Allergy Clin Immunol 103(3 Pt 1):436–440
Weingarten SR, Henning JM, Badamgarav E, Knight K, Hasselblad V, Gano A Jr, Ofman JJ (2002) Interventions used in disease management programmes for patients with chronic illness-which ones work? Meta-analysis of published reports. BMJ 325:925
Haubrock M, Daschner A, Diepgen TL, Fartasch M, Gieler U, Korsch E, Kupfer J, Lob-Corzilius T, Ring J, Scheewe S, Scheidt R, Schmid-Ott G, Schnop C, Staab D, Wahn U, Werfel T, Wittenmeier M, Szczepanski R (2009) Gesundheitsökonomische Aspekte der Prävention im Rahmen des Modellvorhabens zur besseren Vorsorge und Versorgung von Kindern und Jugendlichen mit atopischem Ekzem (Neurodermitis) [Health economic aspects of prevention measures in the framework of a research project for improved prevention and provision concepts for children and adolescents suffering from neurodermatitis, A national, prospective multi-centre project for the development and evaluation of a standardised patient training course programme (GADIS)]. Gesundh ökon Qual manag 14:91–199
Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Asthma, 2. Auflage. 2009 [cited: 27.01.2010]. Available from: http://www.versorgungsleitlinien.de/themen/asthma
Acknowlegdement
The study was supported by Merck, Sharp and Dome (MSD) Germany, and sponsored by Arbeitsgemeinschaft Asthmaschulung im Kindes- und Jugendalter e.V., Osnabrück, Germany
Conflict of interest
The authors declare that they have no financial relationship with the organizations that sponsored the research and no other conflict of interest.
Author information
Authors and Affiliations
Consortia
Corresponding author
Appendix
Appendix
Asthmaschulungen für Eltern von Vorschulkindern
The ASEV Study group
Rights and permissions
About this article
Cite this article
Szczepanski, R., Jaeschke, R., Spindler, T. et al. Preschoolers' and parents' asthma education trial (P2AET)—a randomized controlled study. Eur J Pediatr 169, 1051–1060 (2010). https://doi.org/10.1007/s00431-010-1173-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-010-1173-z