Bansal Eshita, Mehra Shuchi, Bhalla Kapil
Department of Paediatrics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
J Family Med Prim Care. 2023 Jul;12(7):1336-1341. doi: 10.4103/jfmpc.jfmpc_1828_22. Epub 2023 Jul 14.
Asthma is a common childhood disease that leads to impairment of quality of life (QOL) of both the children affected by the disease and their caregivers. Management of asthma includes pharmacotherapy along with education about asthma and its self-management, which is most often given verbally. There is limited evidence regarding the benefits of using a written asthma action plan (WAAP) that has been improved using pictorial representation.
The study aimed to assess the effectiveness of a WAAP in improving the QOL of children with bronchial asthma and also of their caregivers. It also educates the patients and families about various triggers and danger signs of an acute attack of asthma.
This was an interventional study with the aim of improving the quality of asthma management. Children of age group 7-17 years in whom the diagnosis of asthma was made and those parents and children who could read and answer the questionnaire (mini-PAQLQ and PACQLQ) were included in the study. Subjects were randomized into Case and Control groups. The intervention was to give the randomly selected patients (Case group) an individualized WAAP along with standard asthma care to both groups. Both groups were followed up to assess and record variations in the quality of life.
The value was highly significant in the following parameters post-intervention: missed doses of controller medication ( value = 0.001), need for rescue medication (<0.001), ACT score (0.001), total PAQLQ (<0.001), and PACQLQ (<0.001) score. Though statistical significance was not established, improvement was also observed in the number of unscheduled OPD visits ( value = 0.082) and hospitalization events ( value = 0.554).
On being provided with the WAAP, the frequency of acute asthma events, treatment compliance, and QOL improved. There was a significant increase in the primary outcomes-PAQLQ and PACQLQ scores. Significant improvement in the secondary outcomes-number of missed school days, missed doses of controller medication, need for rescue medication, and ACT score was also observed.
哮喘是一种常见的儿童疾病，会损害患病儿童及其照料者的生活质量（QOL）。哮喘的管理包括药物治疗以及有关哮喘及其自我管理的教育，这种教育通常以口头形式进行。关于使用经过图片展示改进的书面哮喘行动计划（WAAP）的益处，证据有限。
本研究旨在评估WAAP对改善支气管哮喘患儿及其照料者生活质量的有效性。它还向患者及其家庭传授哮喘急性发作的各种触发因素和危险信号。
这是一项旨在改善哮喘管理质量的干预性研究。研究纳入了7至17岁已确诊哮喘的儿童以及那些能够阅读并回答问卷（儿童版生活质量问卷[mini - PAQLQ]和家长版生活质量问卷[PACQLQ]）的家长和儿童。受试者被随机分为病例组和对照组。干预措施是为随机选择的患者（病例组）提供一份个性化的WAAP，并对两组都提供标准的哮喘护理。对两组进行随访，以评估和记录生活质量的变化。
干预后，以下参数的 值具有高度显著性：控制药物漏服剂量（ 值 = 0.001）、急救药物需求（<0.001）、哮喘控制测试（ACT）评分（0.001）、儿童版生活质量问卷总分（<0.001）以及家长版生活质量问卷总分（<0.001）。尽管未确立统计学显著性，但在非计划门诊就诊次数（ 值 = 0.082）和住院事件（ 值 = 0.554）方面也观察到了改善。
在提供WAAP后，哮喘急性发作的频率、治疗依从性和生活质量均得到改善。主要结局指标——儿童版生活质量问卷和家长版生活质量问卷评分显著提高。次要结局指标——缺课天数、控制药物漏服剂量、急救药物需求和ACT评分也有显著改善。
