Educational interventions for asthma in children

  • Review
  • Intervention




Self-management education programs have been developed for children with asthma, but it is unclear whether such programs improve outcomes.


To determine the efficacy of asthma self-management education on health outcomes in children.

Search methods

Systematic search of the Cochrane Airways Group's Special Register of Controlled Trials and PSYCHLIT, and hand searches of the reference lists of relevant review articles.

Selection criteria

Randomized and controlled clinical trials of asthma self-management education programs in children and adolescents aged 2 to 18 years.

Data collection and analysis

All studies were assessed independently by two reviewers. Disagreements were settled by consensus. Study authors were contacted for missing data or to verify methods. Subgroup analyses examined the impact of type and intensity of educational intervention, self-management strategy, trial type, asthma severity, adequacy of follow-up, and study quality.

Main results

Of 45 trials identified, 32 studies involving 3706 patients were eligible. Asthma education programs were associated with moderate improvement in measures of airflow (standardized mean difference [SMD] 0.50, 95% confidence interval [CI] 0.25 to 0.75) and self-efficacy scales (SMD 0.36, 95% CI 0.15 to 0.57). Education programs were associated with modest reductions in days of school absence (SMD -0.14, 95% CI -0.23 to -0.04), days of restricted activity (SMD -0.29, 95% CI -0.49 to -0.08), and emergency room visits (SMD -0.21, 95% CI -0.33 to -0.09). There was a reduction in nights disturbed by asthma when pooled using a fixed-effects but not a random-effects model. Effects of education were greater for most outcomes in moderate-severe, compared with mild-moderate asthma, and among studies employing peak flow versus symptom-based strategies. Effects were evident within the first six months, but for measures of morbidity and health care utilization, were more evident by 12 months.

Authors' conclusions

Asthma self-management education programs in children improve a wide range of measures of outcome. Self-management education directed to prevention and management of attacks should be incorporated into routine asthma care. Conclusions about the relative effectiveness of the various components are limited by the lack of direct comparisons. Future trials of asthma education programs should focus on morbidity and functional status outcomes, including quality of life, and involve direct comparisons of the various components of interventions.








系統性的搜尋the Cochrane Airways Group's Special Register of Controlled Trials及PSYCHLIT並且手工搜尋有關評估文章的參考文獻目錄。






在被找到的45個試驗中,32個研究包含3706的合格病人。氣喘教育課程有溫和的改善其測量氣流(標準化平均差[SMD] 0.50,95%信賴區間[CI] 0.25至0.75)和自我效益評量表(SMD 0.36,95%CI為0.15~0.57)。教育課程有適度的減少缺課天數(SMD −0.14,95%CI為 −0.23至−0.04),限制活動的天數(SMD 0.29,95%CI為 −0.49至0.08),和急診治療的頻率(SMD 0.21,95%CI為 −0.33至−0.09)。對於晚間發作氣喘有減少,當使用使用固定效果而不是隨機效果方式分析。在與輕中度氣喘相比的中重度病患及以尖峰流量相對於症狀為基礎的策略研究中,大部分分析結果顯示教育的影響較大。效果在起初6個月很明顯,但發病率的測量和醫療保健的利用則於12個月間均很明顯。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Educational interventions for asthma in children

Learning self-management strategies related to asthma prevention or attack management can help improve children's lung function and feelings of self-control, as well as reduce school absences and days of restricted activity and decrease emergency room utilization. There were no differences in the risk or frequency of hospitalizations between usual care and care supplemented with self-management education. These types of more rare and serious events may be beyond the ability of education to influence. While more research is needed to make direct comparisons between different types of interventions, the limited evidence currently available suggests that in general, self-management education works well for persons with moderate-to-severe asthma as well as for those with mild-to-moderate asthma. Peak flow-based educational strategies generally show greater effects than symptom-based strategies. Beneficial effects on measures of physiological function were apparent within six months, but benefits did not become fully apparent on measures of morbidity or health care utilization until 7 to 12 months following enrolment in an educational program.