Abstract

A problem
Approximately, 59,00 children in Wales have been diagnosed with asthma. Two thirds of school aged asthmatics will have an asthma attack in school.
NRAD (2014) highlighted that in children, poor perception of risk of adverse outcome was found to be an important avoidable factor in 70% of the deaths that were looked at, as well as poor prescribing practice, lack of a structured asthma review with a specialist and a lack of a personal asthma action plan. The recent NACAP CRY audit supports this view.
An Aim
To educate and empower the pupils, their parents and teachers about asthma to enable them to self-manage their condition.
Conduct the reviews in a child friendly environment to encourage full participation from the patient.
An Outline
Hold group sessions with the staff and the parents of all pupils who had a reliever inhaler in the school.
Concentrate on
• correct diagnosis,
• asthma pathophysiology,
• good asthma control,
• action and use of medication,
• adherence,
• inhaler technique,
• recognising and safely managing worsening symptoms with personal asthma action plan.
Review pupils in the school with read/write access to the surgery PMR.
Aim for
• diagnostic certainty
• treatment optimisation
• education, education, education about
o asthma
o medication
o inhaler technique
o self-management.
• treat other atopy
• follow up in the school.
Findings
Many pupils and parents were unclear about their diagnosis.
The understanding of the pathophysiology of asthma and the action and use of asthma medication was poor.
None had an asthma action plan.
Repeated A&E attendance without follow up was common.
An asthma review in a school allows the child to play a bigger part in the review.
With appropriate treatment and education, pupils’ asthma management improves.
Following the consultation there were
• no unscheduled care visits
• improved school attendance
• increased sports participation
• increased quality of life (using ACT)