Background: Non-adherence to asthma medications is associated with frequent emergency room visits, hospitalizations and use of oral corticosteroids. The aim of the study is to assess if coaching asthmatic children via house visits will improve adherence to medical regimens and therefore reduce respiratory morbidity and health care utilization.
Methods: A prospective interventional pilot study enrolling children aged 3-18 years, admitted to Soroka Medical Center between October 2015 and May 2016 due to asthma exacerbation. The children were coached by a pediatric pulmonologist in the clinic and by highly trained nurse in house visits. The control group included asthmatic children who were admitted during the same time period, but didn`t go through any intervention. Medication purchase and health care utilization were extracted from the ‘Clalit’ HMO databases. Asthma control was assessed through self - questionnaires (Asthma Control Test™).
Results: The intervention group included 42 children (mean age 7 years) with matched 212 children in the control group. The intervention group consumed significantly more asthma medications, controllers and relievers (median 6.5, IQR 3-13), when compared to the control group (median 4, IQR 2-9, p-value 0.023). There was no significant difference in the number of clinic visits between the two groups. There was a significant improvement in the subjective feeling of asthma control as reflected from the questionnaires, filled before and after the intervention (p-value<0.001).
Conclusion: Coaching asthmatic children via house visits was found to be associated with higher asthma medications consumption, similar ER visits & hospitalizations and an improvement in ACT questionnaires.
