Abstract
Aim: To evaluate the effectiveness of a programme of asthma clubs in improving quality of life in primary school children with asthma.
Methods: A cluster randomised intervention trial was undertaken in 22 primary schools within the urban area of south and east Belfast, Northern Ireland. Schools were randomised in pairs to immediate or delayed groups. The study subjects comprised 173 children aged 7–11 years whose parents had notified the school of their asthma diagnosis. Children attended school based weekly clubs over an 8 week period. The main outcome measures were the interview administered Paediatric Quality of Life Questionnaire scores, ranging from 1 (worst) to 7 (best), spirometry, and inhaler technique.
Results: Over 15 weeks, small but non-significant improvements in the overall quality of life score (mean 0.20; 95% confidence interval (CI) –0.20 to 0.61) and in each of its three components, activity limitation (0.20; –0.43 to 0.84), symptoms (0.23; –0.23 to 0.70), and emotional function (0.17; –0.18 to 0.52), were observed in the immediate compared with the delayed group. Inhaler technique at week 16 was markedly better in the immediate group, with 56% having correct technique compared with 15% in the delayed group. No significant effect of the intervention on spirometry results could be demonstrated.
Conclusion: This primary school based asthma education programme resulted in sustained improvements in inhaler technique, but changes in quality of life scores were not significant.
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Figure 1.
Trial profile.
Figure 2.
Changes in mean quality of life scores by treatment group during the trial. (A), activity limitation; (B) symptoms; (C) emotional functioning; (D) overall.
Figure 3.
Random effects meta-analysis of changes over 15 weeks (week 16 minus week 1) in overall quality of life scores for 173 participants in 11 pairs of schools.
Selected References
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