Khan M S R, O'Meara M, Stevermuer T L, Henry R L
School of Women's and Children's Health, University of New South Wales, Australia.
J Paediatr Child Health. 2004 Dec;40(12):674-7. doi: 10.1111/j.1440-1754.2004.00490.x.
To test the hypothesis that reinforcement of the advice given at the time of discharge from the emergency department by telephone consultation would improve asthma outcomes.
A randomized controlled trial of the parents of 310 children who had been discharged from the emergency department with asthma was undertaken. The parents were randomized to receive either standard care (155 children) or standard care plus education by telephone (155 children) from a trained asthma educator. Symptoms, parental asthma knowledge, parental quality of life and use of asthma action plans and preventer therapy were collected at baseline and 6 months later. The primary measure was days of wheeze in last 3 months; intermediate measures were regular use of preventer medications, possession and use of written asthma action plan, parental asthma knowledge scores and parental quality of life scores.
A total of 266 parents (136 intervention) completed the follow-up questionnaires after 6 months. Both groups showed similar symptoms and process measures at baseline, apart from more regular use of preventer medication in the control children. At follow up, the intervention group children were significantly more likely than controls to possess (87.5% vs 72.3%; P = 0.002) a written asthma action plan. Possession of action plans increased from baseline in the intervention group but tended to decrease in the control group. Use of action plans was greater in the intervention group but decreased from baseline in both groups. Both intervention and control groups showed significant decreases in asthma symptoms.
Reinforcement by telephone consultation did not improve the primary outcome of wheeze in the last 3 months. However, it increased the possession and regular use of written asthma action plans in the intervention group.
检验通过电话咨询强化急诊出院时所给予建议可改善哮喘治疗效果这一假设。
对310名因哮喘从急诊科出院的儿童的家长进行了一项随机对照试验。家长们被随机分为两组，一组接受标准护理（155名儿童），另一组接受标准护理加来自经过培训的哮喘教育者的电话教育（155名儿童）。在基线期和6个月后收集症状、家长的哮喘知识、家长的生活质量以及哮喘行动计划和预防治疗的使用情况。主要指标是过去3个月的喘息天数；中间指标是预防药物的常规使用、书面哮喘行动计划的持有和使用、家长哮喘知识得分以及家长生活质量得分。
6个月后共有266名家长（136名干预组）完成了随访问卷。两组在基线期的症状和过程指标相似，但对照组儿童预防药物的使用更规律。随访时，干预组儿童比对照组儿童更有可能持有书面哮喘行动计划（87.5%对72.3%；P = 0.002）。干预组持有行动计划的比例从基线期有所增加，而对照组则呈下降趋势。干预组行动计划的使用更多，但两组均较基线期有所减少。干预组和对照组的哮喘症状均显著减轻。
电话咨询强化并未改善过去3个月喘息的主要结局。然而，它增加了干预组书面哮喘行动计划的持有和常规使用。
