School-supervised asthma controller strategy

Abstract

Background: Asthma is a very common chronic respiratory disease present worldwide and affecting all age groups. Prevalence among children in Spain is around 10% but its mortality levels are low. Adherence is defined as the ability of a patient to follow correctly the agreed treatment and change its daily habits. Education is a main factor to achieve good adherence levels in chronic diseases. The lack of adherence implies a sustained pro-inflammatory status, more symptomatology, increased risk of exacerbations, progressive loss of lung function and a subsequent huge amount of direct and indirect costs. Aim: To analyze the effect of a new asthma treatment strategy based on school-supervision in which patients will have their controller medication during school time and under the supervision of their teachers. This strategy is expected to reduce the number of emergency department visits and admissions to hospital due to asthma worsening, since these features weigh greatly on asthma-related expenses and the use of sanitary resources. Methods: A prospective multicenter clinical trial will be performed following 186 patients diagnosed with asthma and the need for inhaled corticosteroid at a low or moderate dosage as controller medication. All Hospitals in Girona Province will participate in this study. Patients will be collected in a combination of cluster and consecutive sampling methods and will be divided into two groups, the intervention and the control group. Intervention: Both groups will be informed equally of all non-pharmacological strategies for asthma management. The intervention group will follow the school-supervised treatment strategy. Outcomes: Asthma control level, ACT score, and the number of total exacerbations, emergency department visits and hospital admissions will be assessed during intervention time. At the end, statistical analysis of collected data will be performed, taking into account all covariables, using multiple regression models