The study results will be presented at the 1997 American Thoracic Society meeting, May 16-21, in San Francisco. Families of 101 children--9 months-16 years old--are participating in the ongoing study. Children and/or parents responded to questions about steroid use, symptom severity, quality of life for the child and parent, and a perceived level of competence in managing asthma symptoms. Researchers collected information at admission to the program, and three, six and 12 month intervals. They will continue to follow the families for two years after they complete the program.
"The reduction in yearly medical costs are very important in societal terms and to managed care," said Donna Bratton, M.D., medical director of the Pediatric Day Program and an author of the study. "Five percent of asthma patients contribute to 70-80 percent of all asthma costs. These patients are very sick and have failed traditional outpatient management. Now these children are managing their asthma with less medication. Some had devastating side-effects caused by long-term steroid use."
The study also found the children use steroids 25 percent less every year following participation in the program. Steroid side-effects include growth suppression, weight gain, thinning bones, high blood pressure and cataracts. By taking part in the Pediatric Day Program, parents and their children with asthma learn new ways to control the disease and have a more normal family life. The program uses physicians, psychologists, nurses, and movement and art therapists to help patients learn about and control asthma, instead of letting asthma control them.
"For severe, chronically ill children, collaborative multi-disciplinary care can improve both medical outcomes and quality of life for the patient," said Leslie Gavin, Ph.D., interim co-director of the Pediatric Day Program and an author of the study. "Many of our children and families have been living compromised lives and accumulating enormous medical expenses. Our program can reduce these expenses and increase quality of life."
Children in the program had a 38 percent decrease in asthma symptoms, while parents experienced a 16 percent increase in their perceived competence of managing their child's illness. Quality of life for the child and the parent increased 31 percent and 22 percent, respectively. In the study, quality of life included how symptoms interfered with daily activities.
"Our research shows there's a significant decrease in the number of symptoms and how much symptoms interfere with a patient's life after participating in the program," Gavin said. "There is a significant increase in the parent and child's quality of life."