Impact of asthma education and/or specialized asthma care on subsequent morbidity in asthmatic children
Background: Randomized controlled trials have shown that asthma education alone or in combination with medical review reduces the risk of subsequent emergency department (ED) visits. Nevertheless, asthma education and specialized care often provided in different settings, which increases the implementation burden in clinical practice. Objectives: In children referred to the Asthma Education Centre (AEC) following an ED visit for asthma, the primary objective was to evaluate the real-life individual and combined impact of an AEC visit and specialized asthma care (SAC) visit on a subsequent ED visit for asthma over the following year. Methods: Retrospective cohort study of children referred to the AEC in the year following an ED visit for asthma. The time to subsequent ED visit for asthma was analyzed by a Cox proportional hazards model with time-varying exposures (AEC and SAC). Results: Compared to the children who did not receive any of the exposures, those who had exposure to AEC alone [Hazard Ratio (HR) =0.68, CI 95% 0.53-0.86] or with SAC (HR=0.43, CI 95% 0.34-0.53) had a decreased risk of an earlier subsequent ED visit. Exposure to SAC alone did not have a statistically significant effect on a subsequent asthma visit for asthma Conclusion: In a cohort of children referred to the AEC following an ED visit for asthma, receiving asthma education with or without specialized care was associated with protection against a subsequent ED visit for asthma.
asthma children education specialized care specialist