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. 1991 Nov 9;303(6811):1169–1174. doi: 10.1136/bmj.303.6811.1169

Can morbidity associated with untreated asthma in primary school children be reduced?: a controlled intervention study.

R Hill 1, J Williams 1, J Britton 1, A Tattersfield 1
PMCID: PMC1671468  PMID: 1747614

Abstract

OBJECTIVE--To determine whether an intervention programme based on existing school and community resources can reduce school absence and improve participation in games lessons and sport in children with unrecognised or undertreated asthma. DESIGN--Parallel group controlled intervention study. SETTING--102 primary schools in Nottingham: 49 were randomised to receive the intervention and 53 to be control schools. SUBJECTS--All children aged 5 to 10 years with parent reported absence from school because of wheezing in the previous year and taking no treatment or beta agonists only. INTERVENTIONS--Children with asthma were referred to their general practitioner for assessment of symptoms and treatment. Teachers were given education on asthma by the school nurse in 44 of the 49 intervention schools. MAIN OUTCOME MEASURES--Changes in school absence and missed games and swimming lessons because of wheezing, and schools' policy towards management of asthma in school. RESULTS--Of 17,432 children screened, 451 met the entry criteria--228 in intervention schools and 223 in control schools. 152 (67%) children in intervention schools visited their general practitioner, of whom 39 (26%) were given a new diagnosis of asthma and 58 (38%) had treatment for asthma increased or changed. Over the next academic year mean (SE) parent reported school absence due to wheezing fell significantly, but to a similar extent, in both intervention and control schools (0.82 (0.11) and 1.09 (0.21) weeks respectively). There was little change in school recorded absence or participation in games lessons and swimming lessons in either group. At the end of the study intervention schools were more likely to have improved aspects of management of asthma in school. CONCLUSION--The intervention resulted in a majority of children being assessed by their general practitioner and improved teachers' understanding and management of asthma, but it did not result in any appreciable reduction in morbidity.

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Selected References

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  1. Anderson H. R., Bailey P. A., Cooper J. S., Palmer J. C. Influence of morbidity, illness label, and social, family, and health service factors on drug treatment of childhood asthma. Lancet. 1981 Nov 7;2(8254):1030–1032. doi: 10.1016/s0140-6736(81)91225-3. [DOI] [PubMed] [Google Scholar]
  2. Anderson H. R., Bailey P. A., Cooper J. S., Palmer J. C., West S. Morbidity and school absence caused by asthma and wheezing illness. Arch Dis Child. 1983 Oct;58(10):777–784. doi: 10.1136/adc.58.10.777. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Anderson H. R. Increase in hospital admissions for childhood asthma: trends in referral, severity, and readmissions from 1970 to 1985 in a health region of the United Kingdom. Thorax. 1989 Aug;44(8):614–619. doi: 10.1136/thx.44.8.614. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Anderson H. R. Is the prevalence of asthma changing? Arch Dis Child. 1989 Jan;64(1):172–175. doi: 10.1136/adc.64.1.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Burney P. G., Chinn S., Rona R. J. Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973-86. BMJ. 1990 May 19;300(6735):1306–1310. doi: 10.1136/bmj.300.6735.1306. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burr M. L., Butland B. K., King S., Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. doi: 10.1136/adc.64.10.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Colver A. F. Community campaign against asthma. Arch Dis Child. 1984 May;59(5):449–452. doi: 10.1136/adc.59.5.449. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Coughlin S. P. Sport and the asthmatic child: a study of exercise-induced asthma and the resultant handicap. J R Coll Gen Pract. 1988 Jun;38(311):253–255. [PMC free article] [PubMed] [Google Scholar]
  9. Haahtela T., Lindholm H., Björkstén F., Koskenvuo K., Laitinen L. A. Prevalence of asthma in Finnish young men. BMJ. 1990 Aug 4;301(6746):266–268. doi: 10.1136/bmj.301.6746.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Heijne den Bak J. Prevalence and management of asthma in children under 16 in one practice. Br Med J (Clin Res Ed) 1986 Jan 18;292(6514):175–176. doi: 10.1136/bmj.292.6514.175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hill R. A., Standen P. J., Tattersfield A. E. Asthma, wheezing, and school absence in primary schools. Arch Dis Child. 1989 Feb;64(2):246–251. doi: 10.1136/adc.64.2.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hill R., Williams J., Tattersfield A., Britton J. Change in use of asthma as a diagnostic label for wheezing illness in schoolchildren. BMJ. 1989 Oct 7;299(6704):898–898. doi: 10.1136/bmj.299.6704.898. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lee D. A., Winslow N. R., Speight A. N., Hey E. N. Prevalence and spectrum of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1256–1258. doi: 10.1136/bmj.286.6373.1256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Levy M., Bell L. General practice audit of asthma in childhood. Br Med J (Clin Res Ed) 1984 Oct 27;289(6452):1115–1116. doi: 10.1136/bmj.289.6452.1115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Speight A. N. Is childhood asthma being underdiagnosed and undertreated? Br Med J. 1978 Jul 29;2(6133):331–332. doi: 10.1136/bmj.2.6133.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Speight A. N., Lee D. A., Hey E. N. Underdiagnosis and undertreatment of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1253–1256. doi: 10.1136/bmj.286.6373.1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Storr J., Barrell E., Lenney W. Asthma in primary schools. Br Med J (Clin Res Ed) 1987 Jul 25;295(6592):251–252. doi: 10.1136/bmj.295.6592.251. [DOI] [PMC free article] [PubMed] [Google Scholar]

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