Evaluation of the feasibility of a school-based asthma management programme in Taiwan

Aims and objectives: To investigate the feasibility of a school-based asthma management programme for middle school children.

Background: Asthma rates are increasing among school-aged children. Successful asthma treatment in children depends in part on clear communication and effective education.

Design: This feasibility study employed a one-group only longitudinal design with four time points over 18 months.

Methods: Nineteen female and twelve male (n = 31) seventh-grade children with asthma (13 SD 0·71 years) were identified using a six-stage asthma case-finding approach. Teachers and school staff were trained in the principles and methods of the proposed school-based asthma management programme. An individualised guided asthma self-management programme was developed for each child by a clinical team at a major academic medical centre. We assisted teachers in implementing the school programme; building a support network and monitoring children's activities. Outcome measures included lung function tests (at 0, six, 12 and 18 months), disease-related symptoms, psychosocial status and impact of asthma on learning (at 0 and 18 months). School provided data on academic achievement and school absences at 0, six, 12 and 18 months.

Results: Significant improvements were noted at six, 12 and 18 months on forced vital capacity (FVC)% of predicted (p = 0·001, 0·015, 0·015, respectively), forced expiratory volume in one second (FEV(1) )% of predicted (p = 0·001, 0·006, 0·088, respectively) and FEV(1) /FVC% of predicted (p = 0·001, 0·015, 0·099, respectively). There was a trend towards improved asthma symptoms (p = 0·050) and a significant decrease in positive perception of curriculum (p = 0·017) at 18 months after adjustment for covariates.

Conclusions: This programme was associated with respiratory benefits on physiological asthma markers commonly, with a trend for symptom control. Academic and psychosocial outcomes are subject of further inquiry.

Relevance to clinical practice: School-based asthma management holds promise as a feasible clinical option for middle school children with asthma in the Taiwanese school system.