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Educational Home Visits Reduce Asthma Attacks, Improve Treatment Adherence in Children BALTIMORE, Md -- December 1, 2009 -- A few home visits by a healthcare specialist to educate children with asthma about basic strategies for earlier symptom recognition and improving medication use can lead to fewer flare-ups and less frequent trips to the ER, according to research from Johns Hopkins Children’s Center published in the December issue of Pediatrics. “We compared several strategies to improve asthma control among children and, much to our delight, we found that taking a few simple steps can go a long way toward doing so,” says Kristin Riekert, Johns Hopkins Adherence Research Center, Baltimore, Maryland. Researchers say the key is providing regular asthma education that includes: · In-the-home demonstration and training on the proper use of inhalers by an asthma specialist and a discussion with the family about regular access to a paediatrician, ensuring they have access to one. · An asthma action plan specifically tailored to each child with a list of must-take daily controller medication, a checklist of what to do when symptoms start, and when to seek emergency care. Researchers compared the effectiveness of 3 different strategies in 250 African-American children with asthma who ended up in the emergency department due to an asthma attack. One group received standard care: a booklet with basic asthma information. The other 2 groups received educational home visits by asthma educators, with 1 group receiving education only, and the other receiving education plus feedback on how well the patient was following their medication instructions -- which researchers determined with the help of a monitoring device on the child’s inhaler that recorded each use -- as well as coaching on how to improve adherence. Follow-up at 6, 12, and 18 months showed that: · Children in the 2 groups that received home visits and whose medication use was monitored had 15% fewer trips to the emergency department compared with children who received standard care. They also had a 52% faster rate of refill of inhaled corticosteroids. · Children who received educational home visits reported on average fewer symptoms per month compared with children who received the informational booklet. · Children who received the standard of care had 12% more emergency department visits and reported 17% higher use of oral corticosteroids compared with children from the other 2 groups. · There was no added value in providing medication monitoring and feedback above providing at-home educational visits alone. · There was no significant difference in the number of hospitalisations among the 3 groups. SOURCE: Pediatrics E-mail this page to a friend or colleague! To print, use this version