Evaluation of an asthma management program for Chinese children with mild-to-moderate asthma in Hong Kong.

There is inconclusive evidence on the efficacy of outpatient clinic-based asthma management programs (AMP) in children. We hypothesized that an AMP based on key symptoms could improve outcome measures of asthma in Chinese children in Hong Kong. This study involved an outpatient clinic-based prospective cohort of Chinese children with asthma. Each patient received one 2-hr session of AMP which was conducted by a pediatric nurse specialist. Asthma outcomes were measured at baseline and at 6 and 12 months after completion of AMP. Demographic data, family history of allergic diseases, and changes in inhaled steroid therapy were also recorded. A total of 106 asthmatic children were enrolled, and they showed a significant decrease in nocturnal cough, wheezing attacks, and subjective assessment of severity at 6 and 12 months following participation in AMP, compared with their baseline status. Acute asthmatic attacks, unscheduled outpatient attendance, emergency room visits, school absenteeism, and number and duration of hospitalizations were also reduced during the follow-up period. Significantly more (21%) children were reported to use inhaled beclomethasone at the end of the study. Nocturnal cough, wheeze, and symptoms due to rhinitis improved significantly after AMP. In conclusion, our cohort of Chinese children with mild-to-moderate asthma used significantly more inhaled corticosteroids and practiced more measures to control house dust mites at the end of the 1-year treatment period. The main reason for better asthma control appeared to be related to the increased use of inhaled steroids, although some additional decrease in nocturnal cough, wheeze, and allergic rhinitis was found after adjusting for the use of inhaled corticosteroids.