Nurse Visits To Asthmatic Children's Homes Help Prevent More Serious Treatment

Main Category: Respiratory / Asthma
Also Included In: Nursing / Midwifery;  Pediatrics / Children's Health
Article Date: 04 Aug 2009 - 7:00 PST

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Nurses who make home visits to children with asthma can help prevent half of those children from having to receive more serious treatment for their condition, suggests research published ahead of print in the Archives of Disease in Childhood.

There are several benefits of a nurse spending time to find potential ways of modifying the child's condition by changing their own home environment, says the UK research.

Most children with asthma control their condition with low-dose inhaled corticosteroids (ICS), but 5-10% have ongoing symptoms and/or severe exacerbations despite treatment with conventional therapy including high dose ICS. The latter group are normally assessed in hospital settings.

Researchers from the Royal Brompton Hospital and Imperial College London studied 71 children aged 4.5 to 17.5 years old who had problematic asthma and were being followed up at a tertiary respiratory centre.

They organised for a nurse-led hospital visit followed by a home visit which involved looking at allergen exposure (particularly house dust mite and pets), smoking, adherence to medication and psychosocial issues.

The home visits by one of two paediatric respiratory nurses took place between February 2005 and June 2008.

The nurses found potentially modifiable factors in 79% of the children's cases.

Many reasons for poor control of their asthma were evident, but the main causes were ongoing exposure to allergens (31% of cases); passive or active smoking in 25% of children; medication issues such as adherence in 48% of cases; and psychosocial factors in 59% of families.

The majority of homes (84%) were taking inadequate steps to avoid house dust mites. In almost a quarter of homes (23%), medications were not easily available for inspection or were out of date.

The nurses identified modifiable factors and made recommendations, which meant that further, more serious treatment for 55% of these children was unnecessary.

The researchers conclude: "Nurse-led assessments including a home visit can help identify potentially modifiable factors for poorly controlled symptoms in children with problematic asthma.

"We believe the home visit makes an important contribution to the assessment of the child with problematic asthma."

"The importance of nurse-led home visits in the assessment of children with problematic asthma."
Arch Dis Child 2009; doi 10.1136/adc.2008.152140

Source
Archives Of Disease In Childhood