Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysisBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7402.1308 (Published 12 June 2003) Cite this as: BMJ 2003;326:1308
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Trial Trial design No of patients (% followed up) Mean age (range) Asthma severity Session type No of sessions Basis of self management strategy Educational strategy Duration of intervention (months) Alexander 1988w1 Randomised controlled trial 21 (100) Not reported (2-13) Moderate-severe Individual 4 Symptoms Prevention, attacks 12 Carswell 1989w2 Randomised controlled trial 86 (100) 11.2 (5-15) Mild-moderate Individual ³1 Peak flow Prevention, attacks 6 Charlton 1994w3 Randomised controlled trial 91 (87) 6.5 (3-16) Unclear Individual 1 Peak flow Prevention, attacks 1 Christiansen 1997w4 Controlled clinical trial 50 (84) 10.4 (9-12) Moderate-severe Group 5 Peak flow Prevention, attacks 1 Clark 1986w5 Randomised controlled trial 308 (83) 9.2 (4-17) Unclear Group 6 Symptoms Prevention, attacks, social skills 6 Colland 1993w6 Randomised controlled trial 112 (100) 10 (8-12) Unclear Group 10 Symptoms Prevention, attacks, social skills 2.5 Dahl 1990w7 Randomised controlled trial 20 (95) 12.2 (not reported) Moderate-severe Individual 4 Peak flow Prevention, attacks, social skills 1 Deaves 1993w8 Controlled clinical trial 64 (98) Not reported (3-16) Moderate-severe Individual 1 Peak flow Prevention, attacks 1 Evans 1987w9 Randomised controlled trial 239 (85) 9.1 (8-11) Mild-moderate Group 6 Symptoms Prevention, attacks, social skills 1 Fireman 1981w10 Controlled clinical trial 26 (100) 7.4 (2-14) Moderate-severe Individual and group 6 Symptoms Prevention, attacks, social skills 12 Hill 1991w11 Randomised controlled trial 451 (66) Not reported (5-10) Moderate-severe Individual and group ³1 Symptoms Attacks 12 Holzheimer 1998w12 Randomised controlled trial 80 (70) 4.5 (2-6) Unclear Group 3 Symptoms Prevention, attacks 4 Hughes 1991w13 Randomised controlled trial 95 (94) 9.7 (6-16) Moderate-severe Individual 6 Peak flow Prevention, attacks 12 Kubly 1984w14 Randomised controlled trial 65 (43) 8.2 (not reported) Unclear Group 3-4 Symptoms Prevention, attacks 1 LeBaron 1985w15 Randomised controlled trial 31 (100) 10.6 (6-17) Mild-moderate Individual 3 Peak flow Prevention 5 Lewis 1984w16 Randomised controlled trial 88 (86) 10.3 (7-12) Moderate-severe Group 5 Symptoms Prevention, attacks, social skills 1 Madge 1997w17 Randomised controlled trial 201 (100) Not reported (2-15) Unclear Individual 3 Peak flow Prevention, attacks, social skills 1 McNabb 1985w18 Randomised controlled trial 16 (94) 10.4 (9-13) Unclear Individual 5 Symptoms Prevention, attacks 1 Mitchell 1986w19 Randomised controlled trial 368 (70) 5.9 (2-14) Unclear Individual 6 Symptoms Prevention, attacks 6 Parcel 1980w20 Controlled clinical trial 104 (100) 7.7 (5-11) Unclear Group 24 Symptoms Prevention, attacks, social skills 6 Perrin 1992w21 Randomised controlled trial 81 (69) 9.3 (6-14) Moderate-severe Group 4 Symptoms Prevention, attacks 1 Persaud 1996w22 Randomised controlled trial 36 (100) 10.2 (8-12) Moderate-severe Individual 8 Peak flow Prevention, attacks, social skills 2 Rakos 1985w23 Randomised controlled trial 43 (100) Not reported (7-12) Moderate-severe Individual 1 Symptoms Prevention, attacks, social skills Unclear Ronchetti 1997w24 Randomised controlled trial 312 (67) 9.6 (6-14) Moderate-severe Group 4-8 Symptoms Prevention, attacks, social skills 1-2 Rubin 1986w25 Randomised controlled trial 65 (83) 9.7 (7-12) Moderate-severe Individual 6 Symptoms Prevention, attacks 10 Shields 1990w26 Randomised controlled trial 253 (81) 8.8 (<19) Unclear Individual and group 8 Symptoms Prevention, attacks 1-2 Szczepanski1996w27 Controlled clinical trial 84 (89) Not reported (not reported) Unclear Group ³11 Peak flow Prevention, attacks 6 Talabere 1993w28 Randomised controlled trial 50 (100) Not reported (8-12) Unclear Individual 2 Symptoms Prevention, attacks, social skills 1 Toelle 1993w29 Controlled clinical trial 132 (91) 9.2 (8-11) Mild-moderate Group 2 Peak flow Prevention, attacks 1 Weingarten 1985w30 Randomised controlled trial 20 (95) Not reported (8-11) Unclear Group 26 Peak flow Prevention, attacks, social skills 2.5 Whitman 1985w31 Randomised controlled trial 38 (100) 8.4 (6-14) Moderate-severe Group 8 Symptoms Prevention, attacks 1 Wilson 1996w32 Randomised controlled trial 76 (84) 3.8 (not reported) Moderate-severe Group 4 Peak flow Prevention, attacks, social skills 1
Trial Allocation concealment* Systematic differences Care provided Follow up Outcome assessment Alexander 1988w1 Unclear Yes No No Carswell 1989w2 Adequate No No No Charlton 1994w3 Adequate Yes No No Christiansen 1997w4 Inadequate No No No Clark 1986w5 Unclear No No No Colland 1993w6 Unclear No No No Dahl 1990w7 Unclear No No No Deaves 1993w8 Inadequate No No No Evans 1987w9 Adequate No No No Fireman 1981w10 Inadequate No No No Hill 1991w11 Unclear Yes Yes No Holzheimer 1998w12 Unclear No Yes No Hughes 1991w13 Adequate Yes No No Kubly 1984w14 Adequate No Yes No LeBaron 1985w15 Unclear No No No Lewis 1984w16 Adequate No No No Madge 1997w17 Adequate No No No McNabb 1985w18 Adequate No No No Mitchell 1986w19 Unclear No Yes No Parcel 1980w20 Inadequate No No No Perrin 1992w21 Unclear No Yes No Persaud 1996w22 Adequate No No No Rakos 1985w23 Unclear No No No Ronchetti 1997w24 Unclear No Yes No Rubin 1986w25 Adequate No Yes No Shields 1990w26 Adequate No No No Szczepanski 1996w27 Inadequate Yes Yes No Talabere 1993w28 Unclear No No No Toelle 1993w29 Inadequate Yes No No Weingarten 1985w30 Unclear No No No Whitman 1985w31 Unclear No No No Wilson 1996w32 Adequate No No No
*Whether allocation to treatment or control group was sufficiently concealed before enrolment.
w1 Alexander JS, Younger RE, Cohen RM, Crawford LV. Effectiveness of a nurse-managed program for children with chronic asthma. J Pediatr Nurs 1988;3:312-7.
w2 Carswell F, Robinson EJ, Hek G, Shenton T. A Bristol experience: benefits and cost of an "asthma nurse" visiting the homes of asthmatic children. Bristol Med Chir J 1989;104:11-2.
w3 Charlton I, Antoniou AG, Atkinson J, Campbell MJ, Chapman E, Mackintosh T, et al. Asthma at the interface: bridging the gap between general practice and a district general hospital. Arch Dis Child 1994;70:313-8.
w4 Christiansen SC, Martin SB, Schleicher NC, Koziol JA, Mathews KP, Zuraw BL. Evaluation of a school-based asthma education program for inner-city children. J Allergy Clin Immunol 1997;100:613-7.
w5 Clark NM, Feldman CH, Evans D, Levison MJ, Wasilewski Y, Mellins RB. The impact of health education on frequency and cost of health care use by low income children with asthma. J Allergy Clin Immunol 1986;78:108-15.
w6 Colland VT. Learning to cope with asthma: a behavioural self-management program for children. Patient Educ Couns 1993;22:141-52.
w7 Dahl J, Gustafsson D, Melin L. Effects of a behavioral treatment program on children with asthma. J Asthma 1990;27:41-6.
w8 Deaves DM. An assessment of the value of health education in the prevention of childhood asthma. J Adv Nurs 1993;18:354-63.
w9 Evans D, Clark NM, Feldman CH, Rips J, Kaplan D, Levison MJ, et al. A school health education program for children with asthma aged 8-11 years. Health Educ Q 1987;14:267-79.
w10 Fireman P, Friday GA, Gira C, Vierthaler WA, Michaels L. Teaching self-management skills to asthmatic children and their parents in an ambulatory care setting. Pediatrics 1981;68:341-8.
w11 Hill R, Williams J, Britton J, Tattersfield A. Can morbidity associated with untreated asthma in primary school children be reduced?: a controlled intervention study. BMJ 1991;303:1169-74.
w12 Holzheimer L, Mohay H, Masters IB. Educating young children about asthma: comparing the effectiveness of a developmentally appropriate asthma education videotape and picture book. Child Care Health Dev 1998;24:85-99.
w13 Hughes DM, McLeod M, Garner B, Goldbloom RB. Controlled trial of a home and ambulatory program for asthmatic children. Pediatrics 1991;87:54-61.
w14 Kubly LS, McClellan MS. Effects of self-care instruction on asthmatic children. Issues Compr Pediatr Nurs 1984;7:121-30.
w15 LeBaron S, Zeltzer LK, Ratner P, Kniker WT. A controlled study of education for improving compliance with cromolyn sodium (Intal): the importance of physician-patient communication. Ann Allergy 1985;55:811-8.
w16 Lewis CE, Rachelefsky G, Lewis MA, De la Sota A, Kaplan M. A randomized trial of A.C.T. (asthma care training) for kids. Pediatrics 1984;74:478-86.
w17 Madge P, McColl J, Paton J. Impact of nurse-led home management training programme in children admitted to hospital with acute asthma: a randomised controlled study. Thorax 1997;52:223-8.
w18 McNabb WL, Wilson-Pessano SR, Hughes GW, Scamagas P. Self-management education of children with asthma: air wise. Am J Public Health 1985;75:1219-20.
w19 Mitchell EA, Ferguson V, Norwood M. Asthma education by community child health nurses. Arch Dis Child 1986;61:1184-9.
w20 Parcel GS, Nader PR, Tiernan K. A health education program for children with asthma. J Dev Behav Pediatr 1980;1:128-32.
w21 Perrin JM, MacLean WE, Gortmaker SL, Asher KN. Improving the psychological status of children with asthma: a randomized controlled trial. J Dev Behav Pediatr 1992;13:241-7.
w22 Persaud DI, Barnett SE, Weller SC, Baldwin CD, Niebuhr V, McCormick DP. An asthma self-management program for children, including instruction in peak flow monitoring by school nurses. J Asthma 1996;33:37-43.
w23 Rakos RF, Grodek MV, Mack KK. The impact of a self-administered behavioral intervention program on pediatric asthma. J Psychosom Res 1985;29:101-8.
w24 Ronchetti R, Indinnimeo L, Bonci E, Corrias A, Evans D, Hindi-Alexander M, et al. Asthma self-management programmes in a population of Italian children: a multicentric study. Eur Respir J 1997;10:1248-53.
w25 Rubin DH, Leventhal JM, Sadock RT, Letovsky E, Schottland P, Clemente I, et al. Educational intervention by computer in childhood asthma: a randomized clinical trial testing the use of a new teaching intervention in childhood asthma. Pediatrics 1986;77:1-10.
w26 Shields MC, Griffin KW, McNabb WL. The effect of a patient education program on emergency room use for inner-city children with asthma. Am J Public Health 1990;80:36-8.
w27 Szczepanski R, Gebert N, Hummelink R, Konning J, Schmidt S, Runde B, et al. Ergebnis einer strukturlerten asthmaschulung im kindesund jugendalter (Outcome of structured asthma education in childhood and adolescence.) Pneumologie 1996;50:544-8. [In German.]
w28 Talabere LR. The effects of an asthma education program on selected health behaviors of school-aged children with asthma. In: Funk SG, ed. Key aspects of caring for the chronically ill: hospital and home. New York: Springer, 1993:319-30.
w29 Toelle BG, Peat JK, Salome CM, Mellis CM, Bauman AE, Woolcock AJ. Evaluation of a community-based asthma management program in a population sample of school children. Med J Aust 1993;158:742-6.
w30 Weingarten MA, Goldberg J, Teperberg Y. A pilot study of the multidisciplinary management of childhood asthma in a family practice. J Asthma 1985;22:261-5.
w31 Whitman N, West D, Brough FK, Welch M. A study of a self-care rehabilitation program in pediatric asthma. Health Educ Q 1985;12:333-42.
w32 Wilson SR, Latini D, Starr NJ, Fish L, Loes LM, Page A, et al. Education of parents of infants and very young children with asthma: a development evaluation of the Wee Wheezers program. J Asthma 1996;33:239-54.
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