[Prospective comparison of child asthma education in the emergency department and at scheduled follow-up consultation].
OBJECTIVE
To assess asthma control in asthmatic children attending the emergency department and to compare it with that for children with scheduled specialist follow-up.


METHODS
Between September 2002 and September 2003, we included asthmatic children aged 6 to 16 years, attending the emergency department (group U) or pulmonology follow-up appointments (group C) at Necker Hospital, Paris, France. We used the Asthma Therapy Assessment Questionnaire (ATAQ), completed by the parents and children aged 10 years and over.


RESULTS
We interviewed 156 families and included 144 (92%) in the final analysis (77 in group U). The 2 groups did not differ in age, sex ratio, age at onset and asthma diagnosis and the frequency of asthma attacks. Children in group U received less daily maintenance treatment (P<0.01) but reported more severe asthma (P<0.05). They had also experienced fewer investigations for their asthma (fewer lung function tests P=0.01 and allergy tests P=0.001). The children in group C had better controlled asthma, as assessed by both the children themselves and their parents. They also had fewer problems relating to the behavior, communication and treatment control domains. The assessment of children and parents were similar in all areas except communication. The children considered their communication problems to be more serious than their parents did. Age-related differences were observed, with older children's parents having more difficulties in all domains investigated.


CONCLUSIONS
Clinicians should consider assessing asthma control in children attending the emergency department. There is clearly an opportunity to improve the quality of asthma education for these children. Clinicians could provide children with a written plan of action for asthma attacks and information about daily self-management. Improving communication between children, their parents and doctors should be considered a key educational project.
Cojocaru
B
B
Université Paris-Descartes, faculté de médecine, APHP, département des urgences pédiatriques, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris cedex 15, France.
de Blic
J
J
Scheinmann
P
P
Chéron
G
G
D000293:Adolescent; D001249:Asthma / Q000534:rehabilitation*; D002648:Child; D004636:Emergency Service, Hospital; D005190:Family; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D010290:Parents / Q000193:education; D010297:Paris; D010353:Patient Education as Topic; D011788:Quality of Life; D011795:Surveys and Questionnaires