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

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.