Asthma Education Intervention Research Articles

The Acceptability of Using Augmented Reality as a Mechanism to Engage Children in Asthma Inhaler Technique Training: Qualitative Interview Study With Deductive Thematic Analysis.

Inhaled medications or inhalers provide first-line pharmacotherapeutic treatment for patients with asthma for both acute symptomatic relief and long-term management to keep symptoms under control. A good technique requires only basic instruction and training; however, a recent study identified that 92% of children do not follow all correct steps when using inhalers. There is a growing interest in technology-enhanced asthma education, with evidence demonstrating improvements in knowledge and treatment adherence. Subsequently, there are calls to explore the role of technology-based solutions in improving asthma management and disease outcomes from public health experts, health professionals, and patients with asthma. Augmented reality (AR) technology is an information delivery mechanism with proven efficacy in educational settings. AR displays digital content in a real-world environment using the camera on a smartphone or tablet device to create an immersive learning experience. The study aimed to evaluate the acceptability of AR as a mechanism for delivering asthma inhaler technique education from the perspective of children with asthma and their parents and health professionals, examined through the theoretical framework of acceptability (TFA). An asthma education resource enhanced with AR technology was created to provide inhaler technique education to children. An iterative co-design process was undertaken with target end users for a qualitative evaluation. The participants were 8 to 12 years old with asthma, their caregivers, and health professionals who had experience in managing asthma. Qualitative data were obtained through semistructured one-on-one interviews. Deductive thematic analysis using TFA was undertaken using NVivo software 2020 to assess the acceptability of AR as a delivery modality for asthma inhaler technique education. Overall, 6 health care professionals, 5 asthmatic children, and 5 caregivers of children with asthma totaled a sample of 16. The use of AR in the asthma inhaler resource was found to be acceptable when responses were examined in accordance with TFA. Each of the 7 component constructs of TFA was coded throughout the 16 interviews, with perceived effectiveness (157 times) and affective attitude (63 times) coded most frequently. Positive responses included the intervention being accessible, easy to use, interesting, and fitting within the users' value systems. Negative responses included the need to maintain an interest in children and concerns about the loss of face-to-face interaction with health professionals. AR appears to be an acceptable modality for delivering asthma education to children when explored using TFA constructs. Although some challenges were identified with the use of AR, the results were predominantly positive. Future designs of asthma education interventions involving AR should consider the results of this study, and further research should focus on the feasibility, usability, and barriers and facilitators of behavior change to ensure the successful implementation and uptake of AR into clinical settings. RR2-10.1177/16094069211042229.

Impact of a Pharmacist-led Educational Intervention on Inhalation Technique among Sudanese Patients with Asthma

The proper use of inhaler devices can improve medication efficacy while decreasing dose and adverse effects. The main objective of this study was to investigate the effect of pharmacist-led asthma education interventions on inhaler techniques. This study was a controlled, randomized, prospective intervention, in Wad Medani Teaching Hospital outpatient clinic, between March and June 2021.Structured questionnaire with validated checklists of inhaler techniques were used to collect data, from patients at baseline and at three months of follow-up, for both intervention and control groups. Paired and independent t-tests were used to monitor the effectiveness of the interventions. A total of 130 asthmatic patients were enrolled in this study. The intervention group contains 70 patients (53.8%), while the control group contains 60 patients (46.2%). The mean score for the inhaler techniques of Pressurized metered-dose inhalers(PMDIs) was (3.50±1.43) for the intervention group at baseline and increased after the intervention to (6.78±0.515), this result was significant at the (P = 0.05) level, and the mean score of the dry powder inhaler technique at the initial of this study in the intervention group was (4.72 ±1.50) this means were improved after the intervention to (6.83± 0.44) this result was statistically significant. There was no significant difference between the control group before and after intervention (P=0.321).This study has shown that the pharmacist-led educational intervention improved the inhalation technique of asthmatic patients. It is important to consider these programs as routine health care to enhance inhaler techniques.

Efficacy of an education session by pharmacists for patients with asthma: A randomised controlled trial

Background: Asthma education interventions are provided by pharmacists in many developed countries, although it is still a matter of concern in developing countries. This study aimed to evaluate the effectiveness of pharmacist education sessions on asthma patients. Methods: A three-month single-blinded randomised control trial was conducted to evaluate the impact of pharmacist education sessions on asthma patients. The 60-minute pharmacist sessions provided education to patients about asthma management. The primary outcome of the study was to measure the change in the score of the asthma control questionnaire (ACQ). Results: The 82 participants who completed the study were grouped into two groups. A clinically significant improvement of p>0.5 in the ACQ score was found in the symptoms and environment domains in the intervention group. A significant difference in the ACQ score was also found between the two groups (p=<0.05) after 1 and 2 months of intervention. The proportion of patients with controlled asthma increased from 26 (63.4%) to 31 (75.6%) after the second follow-up in the intervention group. Furthermore, a significant increase (p=0.043) in the AQLQ score was noticed from 4.834 at baseline to 5.433 after the intervention. Conclusion: This study concluded that short-time pharmacist education sessions could improve patients asthma status and quality of life.

Pediatric Hospital Medicine Needs More Randomized Controlled Trials.

Pediatric Hospital Medicine Needs More Randomized Controlled Trials.

Interactive Inpatient Asthma Education: A Randomized Controlled Trial.

Inpatient asthma education interventions provide benefit compared with usual care, but evaluation of the most effective educational model is needed. We compared the impact of interactive versus didactic inpatient pediatric asthma education on subsequent emergency department (ED) visits and hospitalizations. Children (aged 2‒16) with asthma admitted to a tertiary care children's hospital with an asthma exacerbation between October 2016 and June 2017 were randomly assigned to interactive or didactic (control) asthma education. The primary outcome was asthma ED visits at 6 and 12 months; secondary outcomes included hospitalizations (6 and 12 months), inhaler technique, asthma knowledge, symptoms, quality of life, and parental management skills at baseline, discharge, and/or 12 months. One hundred forty participants (69 interactive, 71 control) completed the study. There were no differences in ED visits at 6 or 12 months. Compared to controls, the interactive group had fewer hospitalizations (10.1% vs 22.5%; P = .04) at 6 months. Inhaler technique in the interactive group improved at discharge (mean change 4.07 [95% confidence interval (CI): 3.21-4.94]) and remained increased at 12 months (P = .03). Patient-reported asthma symptoms and quality of life were similar in both groups at baseline (19.9 vs 20.62, best possible score 8) and significantly improved in the interactive group at 12 months (least square mean change, 3.52 vs -1.75; P < .01). There were no differences in ED visits; however, the interactive education reduced asthma hospitalizations over a 6-month period. These findings demonstrate that educational delivery methods can play a role in improving clinical outcomes for asthma.

Effectiveness of a Home- and School-Based Asthma Educational Program for Head Start Children With Asthma: A Randomized Clinical Trial

To evaluate if a multilevel home and preschool asthma educational program is more effective in improving asthma control, compared with a preschool-based program alone. Specifically, because this study was conducted within the Head Start program and targeted at an at risk population, with the study, the researchers examined if their multilevel intervention could address asthma disparities.Eligible participants were caregivers with children aged 2 to 6 years with the confirmed physician-diagnosed of asthma who were also enrolled in one of 14 Head Start programs in Baltimore, Maryland. Participants were recruited from April 1, 2011, to November 31, 2016.Screening forms were provided through Head Start staff, and families who gave permission were contacted by telephone to confirm eligibility and schedule the first home visit. Families were randomly assigned to either the Action for a Better Community (ABC) Plus Head Start education group or the Head Start education alone group by using a 1:1 block randomization scheme. Families were not blinded to their random assignment, but the research assistants who completed assessments were blinded and were different from the intervention staff. The ABC family intervention consisted of 4 30- to 45-minute in-person, at-home asthma management educational sessions and 3 booster calls. Assessment visits were completed by research assistants: in home visits at baseline and 6 months and telephone visits at 3, 9, and 12 months. The primary outcome was the Test for Respiratory and Asthma Control in Kids (TRACK) score to assess the degree of asthma control. Caregiver reports of emergency department visits, hospitalizations, and courses of oral corticosteroids (OCS) in the previous 3 months were collected at each assessment visit. Caregiver health–related quality of life was measured by using the Pediatric Asthma Caregiver’s Quality of Life Questionnaire.A total of 398 families were randomly assigned to either the ABC Plus Head Start educational program (n = 199) or Head Start educational program alone (n = 199). Most participants were Black (379 [95.2%]) and had a family income of less than $40 000 a year (357 [89.7%]). There were no significant group differences on any demographic characteristic. Of those in the intervention group, 144 (72.4%) completed at least 1 home education session, 69 (34.7%) completed all 4 home visits, and 71 (35.8%) completed all the booster telephone calls after the 3-, 6-, and 9-month follow-up surveys. Although there was an overall improvement in TRACK total scores for both groups over time (β = 3.00; 95% confidence interval (CI): 2.47 to 3.54; P < .001), those in the intervention group had clinically significant score differences at 3 months, compared with that of those in the control group (β = 6.26; 95% CI: 1.77 to 10.75; P < .001). There was no significant difference in TRACK scores among groups at months 6, 9, and 12. Participants in the intervention group were significantly less likely to have OCS use at 9 months (β = −0.61; 95% CI: −1.13 to −0.09; P = .02) and hospitalization during the 12-month follow-up period (odds ratio: 0.36; 95% CI: 0.21 to 0.61; P < .001). There was a significant improvement in asthma-related quality of life at 12 months for both groups (β = 0.28; 95% CI: 0.19 to 0.38; P < .001) but no difference between intervention and control groups.The multilevel asthma education intervention decreased several measures including asthma symptom scores at 3 months, OCS use at 9 months, and decreased hospitalizations during the 12-month follow-up period.This educational program revealed modest improvements in asthma control and health care use. It is not entirely clear why TRACK scores only revealed differences at 3 months and OCS use at 9 months; however, the decrease in asthma hospitalization during 12-month follow-up indicates a true significant effect, especially because preschool-aged children have the highest risk for use of health care services. However, it should be noted that health care resources for asthma outcomes was collected via caregiver report and not verified by using medical records, possibly leading to bias. Overall, with this study, the authors highlight how implementation of an asthma educational program by using a community partner was an effective strategy for targeting a population disproportionately affected by health disparities.

Isn't There an App for That? The Role of Smartphone and Tablet Applications for Asthma Education and Self-Management in Adolescents.

Asthma is one of the most common chronic diseases worldwide, with a substantial proportion of the asthma population being children and adolescents. Self-management is recognized as a key component to asthma management, with multiple international guidelines emphasizing the need for adequate self-management skills for good asthma control. Unfortunately, the uptake amongst young people and adolescents is low, with often suboptimal engagement to self-management education and skills contributing to poor adherence to medication as well as poor perception of asthma symptoms. Innovative solutions to deliver education and self-management to adolescents are clearly needed. mHealth is the use of mobile devices such as smartphones and tablet devices to improve healthcare and has been used in multiple chronic diseases. This review articles explores the current use of mHealth in asthma, specifically smartphone and tablet applications as a generation-appropriate, accessible delivery modality for provision of asthma education and self-management interventions in adolescents. Current evidence gaps are also highlighted, which should be addressed in future research.

School-Based Asthma Education Intervention is Associated with Improved Asthma Knowledge in Spanish bi-lingual children with asthma

A multicomponent school-nurse led intervention consisting of asthma education and asthma preventive therapy supervision is an innovative way to reduce asthma disparities in students with asthma attending a Spanish dual-language elementary school

Leveraging the Electronic Medical Record to Increase Distribution of Low Literacy Asthma Education in the Emergency Department.

Though low literacy asthma education is effective at reducing emergency department (ED) use, few interventions are administered in the ED. The aim was to increase the number of parents of children with asthma receiving education in the ED to 50% receiving written and 30% receiving video education over 12 months. Using quality improvement methods, the team planned interventions including improvement of nursing workflow and availability of written and video education. Nurse champions performed peer-to-peer education regarding educational materials and health literacy-focused communication. An asthma education order opening the nursing flowsheet, which linked to written and video materials and documentation was created. The order was placed in highly used ED asthma order sets. The percent of parents receiving written or video education was followed on statistical process control charts. Balancing measures included: ED length of stay, discharge length, 30 day ED return visits, and 365 day return visits with hospitalization. The mean number of parents receiving written education at baseline was 28% and improved to 52%. Special cause variation was noted after order roll-out. Video education increased from a baseline of 0% of parents receiving to 32% with special cause variation after order roll-out. No special cause was noted in balancing measures. Revisits with hospitalization within 365 days showed a decreasing trend after order roll-out. Implementation of workflow improvement, education, and the addition of a functional education order in an existing order set led to a meaningful improvement in distribution of a low literacy asthma education intervention.

Sustained Effects From a School-Based Intervention Pilot Study for Children With Asthma and Anxiety.

Children with chronic conditions (i.e., asthma) are more likely to have anxiety or depressive symptoms. Comorbid asthma and anxiety in children leads to increased morbidity, causing children to miss instructional time and parent/caregiver (CG) work absences. Asthma educational programs and mental health interventions have been developed, though no scalable programs integrate asthma education and mental health behavioral interventions for school-aged children. This study evaluated the sustained preliminary effects of an integrated asthma education and cognitive behavioral skills-building program, Creating Opportunities for Personal Empowerment for Asthma. Thirty-two children ages 8-12 years with asthma and symptoms of anxiety received the intervention. At 6-weeks postintervention, anxiety and CG-reported behavioral symptoms were significantly reduced, there were fewer missed doses of asthma controller medications, and asthma-related self-efficacy, personal beliefs, and the children's understanding of asthma significantly increased. Most children (n = 29, 91%) reported continued use of coping skills.

Community Health Workers' Role in Supporting Pediatric Asthma Management: A Review.

Community Health Workers (CHWs) have been effective in improving health outcomes in vulnerable communities by providing health education and management services. We review CHW-led asthma education and management interventions for children and their families. Next, we describe the selection and training of CHWs in pediatric asthma management in the Rhode Island Integrated Response Asthma Care Implementation Program (RI-AIR). We queried the MEDLine, Cochrane, PubMed, and EMBASE databases with keywords ("community health worker", "asthma", "health worker", "lay worker", "pediatric", "child", and "childhood") from inception until September 2019. Criteria for study inclusion included: published in English, conducted in the United States, approved with an ethics notification, published in peer-reviewed journal, and involved CHWs as the interventionists. The initial search identified 216 manuscripts. Fifteen studies met criteria for inclusion. CHWs provide asthma management and education services, including home environmental trigger assessments, strategies to reduce environmental trigger exposure, resource linkage, and community referrals. We describe RI-AIR, and its CHW-led asthma education and management interventions. CHWs are effective and vital supports for positive asthma outcomes. More research is needed to guide models of intervention using CHWs, specifically addressing integration in interdisciplinary teams, training, and reimbursement for CHW services. CHWs are effective in helping children with asthma and their families learn to manage asthma. It is important to develop programs that prepare CHWs to work with other medical professionals and health care models to pay for their services.

Assessment of a University-Based Outpatient Asthma Education Program for Children.

To assess the effect of a pediatric asthma intervention program on reducing asthma morbidity. Study eligibility criteria included aged less than 18 years and at least two office visits for asthma in the previous year. Patients were randomly assigned to either the control or intent to intervene group. The intervention included home visits and education on the basic pathophysiology of asthma, self-management techniques, modification of asthma triggers, and proper use of asthma medications by a certified nurse educator. Using simple randomization, 901 eligible pediatric patients with asthma were assigned; 458 to the control and 443 to the intent to intervene group. Of the 443 patients randomized to the intent to intervene group, 271 received the asthma education intervention. Most of the remaining 172 patients in the intent to intervene group did not receive the intervention owing to not having an appointment during the study period. Only 27 families allowed a home visit. After controlling for the difference in sex, children in the intent to intervene group had significantly less total clinic visits (incidence rate ratio [IRR] = 0.53, p < .01), and steroid bursts (IRR = 0.47, p < .01) than controls. The implementation of a pediatric asthma education program decreased both the total clinic visits and the need for steroid bursts consistent with better asthma control. We demonstrated the benefit of a dedicated asthma educator in university-based community practice and recommend this intervention be considered a standard of care for children with asthma in all health-care settings.

Asthma Hospitalizations Among Homeless Children in New York State.

Asthma is widely prevalent among US children, particularly in homeless children, who often lack proper medication storage or the ability to avoid environmental triggers. In this study, we assess asthma-attributed health care use among homeless youth. We hypothesize that asthma hospitalization rates, symptom severity, and admission through the emergency department (ED) will be higher among homeless youth compared with nonhomeless youth. This secondary data analysis identified homeless and nonhomeless pediatric patients (<18 years old) with a primary diagnosis of asthma from New York statewide inpatient databases between 2009 and 2014. Hospitalization rate, readmission rate, admission through the ED, ventilation use, ICU admittance, hospitalization cost, and length of stay were measured. We identified 71 837 asthma hospitalizations, yielding 73.8 and 2.3 hospitalizations per 1000 homeless and nonhomeless children, respectively. Hospitalization rates varied by nonhomeless income quartile, with low-income children experiencing higher rates (5.4) of hospitalization. Readmissions accounted for 16.0% of homeless and 12.5% of nonhomeless hospitalizations. Compared with nonhomeless patients, homeless patients were more likely to be admitted from the ED (odds ratio 1.96; 95% confidence interval: 1.82-2.12; P < .01), and among patients >5 years old, homeless patients were more likely to receive ventilation (odds ratio 1.45; 95% confidence interval: 1.01-2.09; P = .04). No significant differences were observed in ICU admittance, cost, or length of stay. Homeless youth experience an asthma hospitalization rate 31 times higher than nonhomeless youth, with higher rates of readmission. Homeless youth live under uniquely challenging circumstances. Tailored asthma control strategies and educational intervention could greatly reduce hospitalizations.

Effect of disease management education on the quality of life and self-efficacy levels of children with asthma.

The aim of this study was to determine the effects of disease management education provided to children with asthma on their quality of life and self-efficacy levels. The study design was a quasi-experimental design with The One Group Pretest-Posttest design. This study was conducted on 60 children with asthma between 10 and 18 years of age. Data were collected by "Information Form", "Pediatric Asthma Quality of Life Questionnaire", and "Self-Efficacy Scale for Children and Adolescents with Asthma". Children's quality of life and self-efficacy levels were assessed before receiving an individual asthma education intervention and then children were informed with an asthma management education book individually. Two months after the education intervention, the quality of life and self-efficacy levels of the children were re-evaluated. The children's quality of life and self-efficacy levels increased significantly after education (p = 0.014). Maternal age, number of siblings, number of family members living in the same house, activity status, the frequency of experiencing symptoms, and the ability to use the inhalers on their own affected children quality of life. Child's age, knowledge about factors causing asthma, and ability to use medication on their own affected their self-efficacy ( p < 0.05). According to these results, planned asthma education program and provided continuity of this education by nurses would be effective to improve the quality of life and levels of self-efficacy. Asthma management education for children with asthma by nurses after diagnosis is beneficial for improving the quality of life and levels of self-efficacy.

A randomized pilot trial of a school-based psychoeducational intervention for children with asthma.

Asthma is a common childhood illness with high morbidity and mortality among minority and socio-economically disadvantaged children. Disparities are not fully accounted for by differences in asthma prevalence, highlighting a need for interventions targeting factors associated with poorer asthma control. One such factor is psychological stress. Here, we examine the feasibility and acceptability of "I Can Cope (ICC)," a school-based stress management and coping intervention for children with asthma. A parallel randomized pilot trial was conducted. One hundred and four low-income children (mean age 10years; 54% male; 70% African American) with persistent asthma were recruited from 12 urban schools and randomized to the following: (a) ICC or one of two control conditions: (b) "Open Airways for Schools (OAS)"-an asthma education intervention or (c) no treatment. Seventy one percentage of eligible children participated in the study, with a dropout rate of 12%. ICC was rated as highly acceptable by participating children and parents. Preliminary efficacy data suggest that when compared with no treatment, ICC resulted in decreased symptoms of depression, perceived stress and child-reported symptoms of asthma, and improvements in sleep quality and child-reported asthma control. There were no intervention-related changes in objective measures of asthma morbidity. The magnitude of intervention effects on psychological function did not differ between the ICC and OAS groups. Results support the feasibility and acceptability of utilizing school-based interventions to access hard to reach children with asthma. Preliminary findings offer support for future, large-scale efficacy studies of school-based interventions designed to target multiple factors that contribute to asthma disparities.

Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas.

ObjectiveIt is well known that parent/patient education helps to reduce the burden of asthma in urban areas, but data are scarce for rural areas. This study explored the impact of asthma education in Ector County, a rural part of Health Services Region 9 in Texas, which has one of the highest prevalence rates of asthma in the state.MethodsThis prospective study investigated an interactive asthma education intervention in pediatric patients aged 2–18 years and their caregivers. Change in parental/caregiver knowledge about their child’s asthma along with frequency of missed school days, emergency department (ED) visits and hospital admissions was obtained via telephone surveys before and after the educational intervention was delivered.ResultsThe study enrolled 102 pediatric patients and their parents/caregivers. Asthma education was associated with significantly fewer school absences, ED visits and hospitalizations. Parents/caregivers reported feeling better educated, knowing what triggers an asthma exacerbation, identifying the signs of a severe asthma attack in their child, feeling confident about managing asthma and feeling that the asthma was under control.ConclusionAsthma education of caregivers and children was associated with better symptom management and fewer acute exacerbations, pointing to the relevance and importance of asthma education among pediatric patients in rural areas.

Results of an asthma education program delivered via telemedicine in rural schools

BackgroundAsthma morbidity is high in low-income children living in rural US regions, yet few interventions have been designed to decrease the asthma burden in rural populations. ObjectiveTo examine the effect of a school-based asthma education program delivered by telemedicine in children living in an impoverished rural region. MethodsWe conducted a cluster randomized trial with rural children 7 to 14 years old by comparing a school-based telemedicine asthma education intervention with usual care. The intervention provided comprehensive asthma education by telemedicine to participants and provided evidence-based treatment recommendations to primary care providers. ResultsOf the 393 enrolled children, median age was 9.6 years, 81% were African American, and 47% lived in households with an annual income less than $14,999. At enrollment, 88% of children reported uncontrolled asthma symptoms. At the end of the intervention, there were no statistically significant differences in reported symptom-free days (primary outcome) for the intervention or usual-care group. Participants in the intervention group reported significantly higher use of peak flow meters to monitor asthma and reported taking their asthma medications as prescribed more frequently compared with the usual-care group. There were no changes in other outcome measures, including quality of life, self-efficacy, asthma knowledge, or lung function, between groups. ConclusionAlthough there was some evidence of behavior change among intervention participants, these changes were inadequate to overcome the significant morbidity experienced by this highly symptomatic rural impoverished population. Future interventions should be designed with a multifaceted approach that considers caregiver engagement, distance barriers, and inadequate access to asthma providers in rural regions. Trial RegistrationClinicalTrials.gov Identifier: NCT01167855.

Exploring young Australian adults’ asthma management to develop an educational video

Objective:This study explored young university students’ (aged 18–24 years) health literacy, asthma experiences and help-seeking behaviours to inform the development of a web-based asthma education intervention relevant to this age group.Design:Exploratory mixed-methods design incorporateing a health literacy survey and interviews, plus the development of a web-based educational video.Setting:Participants were students at two universities in the state of Victoria, Australia.Method:In total, 20 asthma sufferers were interviewed by trained pairs of university students. Interpretative phenomenology underpinned the narrative analysis and enabled the description of the participants’ lived experience. A branching e-simulation video was developed.Results:A number of key themes were identified: ‘Life with asthma’, including ‘A life of vigilance’ regarding asthma triggers, lifestyle limitations and heightened sensitivities; ‘Asthma management – call Mum’, a lack of knowledge and support systems with substantial ma...

Economic evidence for nonpharmacological asthma management interventions: A systematic review.

Asthma management, education and environmental interventions have been reported as cost‐effective in a previous review (Pharm Pract (Granada), 2014;12:493), but methods used to estimate costs and outcomes were not discussed in detail. This review updates the previous review by providing economic evidence on the cost‐effectiveness of studies identified after 2012, and a detailed assessment of the methods used in all identified studies. Twelve databases were searched from 1990 to January 2016, and studies included economic evaluations, asthma subjects and nonpharmacological interventions written in English. Sixty‐four studies were included. Of these, 15 were found in addition to the earlier review; 53% were rated fair in quality and 47% high. Education and self‐management interventions were the most cost‐effective, in line with the earlier review. Self‐reporting was the most common method used to gather resource‐use data, accompanied by bottom‐up approaches to estimate costs. Main outcome measures were asthma‐related hospitalizations (69%), quality of life (41%) and utility (38%), with AQLQ and the EQ‐5D being the most common questionnaires measured prospectively at fixed time points. More rigorous costing methods are needed with a more common quality of life tool to aid greater replicability and comparability amongst asthma studies.

A cost-effectiveness threshold analysis of a multidisciplinary structured educational intervention in pediatric asthma

ABSTRACTObjective: Asthma educational interventions have been shown to improve several clinically and economically important outcomes. However, these interventions are costly in themselves and could lead to even higher disease costs. A cost-effectiveness threshold analysis would be helpful in determining the threshold value of the cost of educational interventions, leading to these interventions being cost-effective. The aim of the present study was to perform a cost-effectiveness threshold analysis to determine the level at which the cost of a pediatric asthma educational intervention would be cost-effective and cost-saving. Methods: A Markov-type model was developed in order to estimate costs and health outcomes of a simulated cohort of pediatric patients with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a single uncontrolled before-and-after study performed with Colombian asthmatic children. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable “quality-adjusted life-years” (QALYs). Results: A deterministic threshold sensitivity analysis showed that the asthma educational intervention will be cost-saving to the health system if its cost is under US$513.20. Additionally, the analysis showed that the cost of the intervention would have to be below US$967.40 in order to be cost-effective. Conclusions: This study identified the level at which the cost of a pediatric asthma educational intervention will be cost-effective and cost-saving for the health system in Colombia. Our findings could be a useful aid for decision makers in efficiently allocating limited resources when planning asthma educational interventions for pediatric patients.