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Evidence summaries

Education for Adults Attending the Emergency Room for Acute Asthma

Educational interventions applied in the emergency department may reduce subsequent asthma admissions to hospital. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 13 studies with a total of 2 157 adult subjects. Education significantly reduced admission to hospital (RR 0.50; 95% CI 0.27 to 0.91); but did not significantly reduce the risk of re-presentation at emergency departments (ED) during follow up (RR 0.66; 95% CI 0.41 to 1.07). There were no statistically significant differences between asthma education and control groups in terms of peak flow, quality of life, study withdrawal and days lost. Two studies from the USA measured costs. One study from the early 1990s measured cost and found no difference for total costs and costs related to physician visits and admissions to hospital. If data were restricted to emergency department treatment, education led to lower costs than control. A study from 2009 showed that associated costs of ED presentation and hospitalisation were lower following educational intervention.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison).

    References

    • Tapp S, Lasserson TJ, Rowe B. Education interventions for adults who attend the emergency room for acute asthma. Cochrane Database Syst Rev 2007 Jul 18;(3):CD003000 [Review content assessed as up-to-date: 23 March 2010]. [PubMed]

Primary/Secondary Keywords