649:
School-based self-management educational interventions for asthma in children and adolescents: A systematic review
Monday, March 5, 2018
South Hall A2 (Convention Center)
Kate M. Harris, Dylan Kneale, Toby Lasserson, Vanessa McDonald, James Thomas, Jonathan Grigg, BSc MB BS MD
RATIONALE: Children with asthma are at risk of asthma exacerbations, unscheduled medical care and school absences. To date, the evidence for schools-based interventions for these adverse outcomes is unclear. We therefore performed a systematic review of the effectiveness of school-based self-management interventions on children's asthma outcomes.

METHODS: We searched 19 databases to identify eligible students for inclusion. The review investigated studies across a range of population groups and environments, including primary/elementary and secondary/high schools. The inclusion criteria stated that interventions must be delivered to children with asthma, aged 5 to 18 years, within the school setting. Meta-analyses were conducted to evaluate the effectiveness of the interventions across 11 outcomes, compared with usual care.

RESULTS: 34 studies, from 7 countries, met the inclusion criteria for the review, and 24 were included in the meta-analyses. School-based interventions were effective in reducing hospitalisations (SMD -0.19, 95% CI -0.35 to -0.04) and emergency department visits (OR 0.71, 95% CI 0.53 to 0.95). Days of restricted activity was also lower among intervention groups (SMD -0.30, 95% CI -0.41 to -0.18). Children in intervention groups also had higher levels of quality of life at follow-up (SMD 0.27, 95% CI 0.18 to 0.36). The effect of the intervention on school absences, day and night time symptoms, and the use of reliever therapies was less consistent.

CONCLUSIONS: School-based interventions for children with asthma are effective in improving a number of outcomes, including quality of life and healthcare use.