Six-year follow-up of an intervention to improve the management of preschool children with asthma.
OBJECTIVE
In a randomized controlled study involving 60 preschool children with asthma, an intervention with extra information and support to parents in the form of group discussions was performed. An earlier follow-up after 18 months revealed an improved adherence and a reduction of exacerbation days. This is a 6-year follow-up.


METHODS
Fifty-four children performed clinical examinations, blood tests, measurements of exhaled nitric oxide, spirometry, bronchial provocation with dry air and skin prick tests. Data from the patients' records and questionnaires were obtained.


RESULTS
Twenty-nine per cent had no current signs of asthma, whereas 43% exhibited persistent and 28% intermittent asthma. The burden on the healthcare system was minimal. Intermittent inhaled corticosteroid (ICS) therapy was used by 81%. The intervention group (IG) had fewer contacts with nurses. Their parents had a better quality of life. Interviewing children separately contributed in identification of children needing treatment. More children in the IG had to restart ICS as they had signs of worse asthma control.


CONCLUSIONS
Straightforward and timely support to parents of children with asthma can have long-term positive effects by strengthening the ability of parents to treat their children at home, although parents may also develop an underestimation of mild symptoms. It is important to directly ask children about their disease and to maintain regular follow-up visits.
Hederos
Carl-Axel
CA
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. carl-axel.hederos@liv.se
Janson
Staffan
S
Hedlin
Gunilla
G
D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D012129:Respiratory Function Tests; D012648:Self Care; D011795:Surveys and Questionnaires