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Asthma self-management programmes in a population of Italian children: a multicentric study
Ronchetti R, Indinnimeo L, Bonci E, Corrias A, Evans D, Hindi-Alexander M, Midulla F, Pulejo R, Villa MP
The European Respiratory Journal 1997 Jun;10(6):1248-1253
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This study was designed to answer three main questions: (1) does asthma self-management education reduce asthma morbidity? (2) Are the two programmes "Living With Asthma" and "Open Airways" equally effective in doing so? (3) Is a shortened version of these programmes (4 weeks) as effective as the longer original programme (8 weeks)? Twelve Italian centres of paediatric bronchopneumology selected 312 children with asthma, who were stratified by disease severity, gender and age, and then randomly assigned to an experimental group which received an educational programme or to a comparison group, which did not. Of the 312 children selected, 209 (114 experimental and 95 comparison) completed the educational protocol and a 1 year follow-up. Data recorded during the last 2 months of follow-up, 10 months after the educational intervention, showed that the experimental group required significantly fewer emergency treatments: this reduction was more evident in the more severe asthma cases. In the experimental, but not in the comparison group, patients with more severe asthma consumed more medications than patients with milder asthma "Open Airways" yielded, in some cases, better results than "Living with Asthma": but a type 2 error is possible. The standard and the shortened programmes proved equally effective. In conclusion, following education, regardless of receiving a short or long educational programme, asthma patients use emergency care services less and use medications more appropriately in comparison with standard care without education. This suggests that short educational programmes can be highly cost-effective in children with asthma.
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