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Improving Asthma Outcomes and Self-Care Behaviors



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Am Fam Physician. 2002 Jul 1;66(1):158-159.

Asthma has a significant impact on the life and well-being of children affected by this disease. Currently, it is estimated that approximately 4.8 million children in the United States have asthma, and prevalence rates are increasing. New treatment programs have been developed in attempts to better control asthma and reduce the number of hospitalizations related to this disease. To achieve goals, children with asthma and their families need to adopt an effective management strategy. Strategies include altering the child's activities and home environment based on his or her particular sensitivities, adjusting the child's medications as determined by his or her physiologic state, and communicating with the child's physician to tailor the treatment regimen. The National Heart, Lung, and Blood Institute recommends that patients monitor their asthma on a daily basis and provide this monitoring information to their clinicians. Guendelman and associates studied the effectiveness of an interactive device programmed for the management of childhood asthma.

The participants in the study were inner-city children, eight to 16 years of age, who were diagnosed with asthma by their physicians. The study included an intervention group and a control group that received standard asthma care. The intervention group received a personal and interactive communication device called the Health Buddy. This device is connected to a home telephone line and can be programmed to present questions on a screen and record responses. A protocol was established consisting of 10 questions about the child's asthma. A nurse sent daily queries using a standard Internet browser. The main outcomes measured included any limitation in daily activities, perceived asthma symptoms, absence from school, any peak flow readings in the yellow or red zones, and use of medications and health services.

The randomized controlled trial included 66 children in the intervention group and 68 in the control group. The children in the intervention group were significantly less likely to have any limitations in activities compared with those in the control group. The intervention group also had fewer peak flow readings in the yellow and red zones and were less likely to make urgent calls to the hospital than the control group. Self-care behaviors for asthma were better in the group that received the Health Buddy device.

The authors conclude that the Health Buddy program improved self-care behaviors and asthma outcomes. The authors note that programs of this kind may empower children to provide more of their own care and reduce the burden on families and the health care system.

Guendelman S, et al. Improving asthma outcomes and self management behaviors of inner-city children. A randomized trial of the Health Buddy interactive device and an asthma diary. Arch Pediatr Adolesc Med. February 2002;156:114–20.



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