Reducing asthma hospitalisations in at-risk children: A systematic review

J Paediatr Child Health. 2021 Sep;57(9):1376-1384. doi: 10.1111/jpc.15666. Epub 2021 Aug 5.

Abstract

Aim: To identify interventions that reduce hospitalisations and improve related outcomes in children at risk of asthma hospital admissions.

Methods: Medline, Embase, Pubmed and Cochrane Library search from January 2002 to April 2020.

Inclusion criteria: randomised controlled trials of any intervention for children with asthma who are at risk of hospitalisations.

Outcomes: hospitalisation (primary outcome), rescue oral corticosteroid use, school absences, quality of life and cost-effectiveness.

Results: Twelve randomised controlled trials were conducted with 2719 participants. Due to heterogeneity of interventions and reporting of outcomes, a meta-analysis was not conducted. Multi-modal interventions comprising caregiver education, reduction of home environmental allergens and regular follow-up reduced hospitalisations, rescue corticosteroid use and improved quality of life. Cost-effectiveness was not reported. Three studies scored an overall low risk of bias, and nine had some concerns.

Conclusion: Multi-modal interventions can be effective in reducing hospitalisations, rescue oral corticosteroid use and quality of life but cost-effectiveness is unknown.

Keywords: asthma; hospitalisations; paediatrics.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Administration, Oral
  • Adrenal Cortex Hormones / therapeutic use
  • Asthma* / drug therapy
  • Asthma* / prevention & control
  • Child
  • Hospitalization
  • Humans
  • Quality of Life*

Substances

  • Adrenal Cortex Hormones