Evaluation and implementation of self-management programs for children with asthma

Abstract

We have reviewed the needs and problems associated with the evaluation and implementation of programs designed to assist children with asthma and their parents to manage the illness. To date, there are several programs that have been evaluated and found to be effective in terms of the objectives and dimensions described. Implementation has presented a larger problem because there are few implementors and because of the major barriers to be overcome by those who would make these programs available to the significant numbers of children and families who would benefit. Unless ways can be found to overcome the medical and reimbursement barriers, asthma self-management programs will not thrive. The growing number of individuals enrolled in some form of health maintenance organization, however, suggests a greater market for asthma self-management programs, under circumstances in which the costs of emergency room use and hospital services must be borne by physicians and hospitals, rather than by their patients.