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Reducing asthma hospitalisations in at-risk children: A systematic review

Katherine Y H Chen1,2,3, Leanne Saxon2, Colin Robertson2,4,5

  • 1Health Services Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|August 5, 2021
PubMed

Insights

Multi-modal interventions, including caregiver education and allergen reduction, effectively reduce childhood asthma hospitalizations and improve quality of life. Cost-effectiveness remains unknown.

Area of Science:

  • Pediatric Pulmonology
  • Public Health
  • Evidence-Based Medicine

Background:

  • Asthma is a leading cause of childhood hospitalizations.
  • Identifying effective interventions is crucial for managing pediatric asthma.
  • Risk stratification for hospital admissions guides targeted management.

Purpose of the Study:

  • To identify interventions that reduce hospitalizations in children at risk of asthma admission.
  • To evaluate the impact of interventions on related outcomes such as rescue medication use and quality of life.

Main Methods:

  • Systematic literature search of Medline, Embase, Pubmed, and Cochrane Library (2002-2020).
  • Inclusion of randomized controlled trials (RCTs) for children with asthma at risk of hospitalization.
  • Assessment of outcomes including hospitalization, rescue oral corticosteroid use, school absences, quality of life, and cost-effectiveness.

Main Results:

  • Twelve RCTs with 2719 participants were analyzed.
  • Due to heterogeneity, a meta-analysis was not performed.
  • Multi-modal interventions (caregiver education, allergen reduction, regular follow-up) reduced hospitalizations, rescue corticosteroid use, and improved quality of life.
  • Three studies had low risk of bias; nine had some concerns.

Conclusions:

  • Multi-modal interventions demonstrate efficacy in reducing asthma-related hospitalizations and improving quality of life in at-risk children.
  • Further research is needed to determine the cost-effectiveness of these interventions.
Abstract

Keywords:
asthmahospitalisationspaediatrics

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