Tailored asthma intervention shows promise

NEW YORK (Reuters Health) - Asthma symptoms and hospital admissions decreased among children whose families participated in a specialized home-based asthma management program, researchers found.

Asthma treatment recommendations can be complex as they require monitoring of specific symptoms and environmental triggers, the researchers note.

Poor asthma management is one of the contributing factors to high asthma rates and asthma-related illness seen in low-income Puerto Rican children, according to Dr. Glorisa Canino, of the University of Puerto Rico, in San Juan. Therefore, she and colleagues compared usual asthma care with a management program targeted specifically at this group.

They enrolled families who used asthma related services through the Puerto Rico Health Insurance Administration Agency Plan during 2004 and 2005. Overall, just 26 percent of the children of these families had controlled asthma, the investigators report in the Journal of Allergy and Clinical Immunology.

A total of 110 families received usual care, which consisted of educational flyers explaining asthma medications and their use, as well as how to prevent environmental asthma triggers, and care for asthma equipment.

Another 108 families completed the culturally tailored intervention that included 8 education sessions taught by asthma counselors and ongoing telephone consultations. This program addressed asthma practices and myths common among Puerto Rican parents, as well as proper use of asthma medications, equipment, home remedies, and asthma triggers specific to the island.

Four months after study enrollment, the investigators found that children in the intervention group had a 6.5 percent increase in symptom-free nights, were 3 times more likely to have their asthma under control, were 37 percent less likely to have visited an emergency department, and were 68 percent less likely to be hospitalized for asthma compared with children who received usual care.

Moreover, caregivers in the intervention group exhibited less frustration and greater confidence in their ability to manage their child's asthma than did caregivers in the usual care group.

These findings highlight promising aspects of this culturally tailored asthma intervention program. The investigators suggest future research to test the long-term efficacy of such programs.

SOURCE: Journal of Allergy and Clinical Immunology, March 2008