L’asthme est la maladie chronique la plus fréquente chez l’enfant. Sa prévalence est en augmentation dans le monde depuis plusieurs années. Plusieurs études ont montré qu’une bonne connaissance de la maladie, associée à des compétences personnelles et à une médication optimale augmentaient la compliance au traitement, diminuaient les absences scolaires et la survenue des crises chez l’enfant. L’École de l’asthme (EA) de l’hôpital de l’Enfance (HEL) s’inscrit dans cette démarche. Nous avons évalué son impact sur la consommation en soins et la qualité de vie des enfants de 4 à 12ans et de leurs parents.

Tous les enfants âgés de 4 à 12ans et leurs parents participant à l’EA ont été inclus pendant 1 an. La consommation en soins pendant 1 année avant et une après l’EA a été évaluée par un questionnaire aux pédiatres. La qualité de vie des enfants et des parents a été évaluée au moyen du Paediatric Asthma Quality of Life Questionnaire (PAQLQ), à l’inclusion et 6 mois après.

Vingt-sept enfants d’âge moyen 7,02ans et leurs parents ont été inclus. La consommation en soins avait diminué significativement dans les trois domaines évalués : consultations en urgences (p=0,021), rendez-vous chez le pédiatre (p=0,010) et hospitalisations (p=0,002). La qualité de vie des enfants et des parents s’était améliorée dans tous les domaines.

L’EA permet de diminuer la consommation en soins et améliore la qualité de vie des enfants et des parents en leur donnant les moyens de mieux gérer la maladie à domicile.

Asthma is the most frequent chronic disease in children. Many educational approaches to asthma exist, but there is no evidence of their effectiveness because of the heterogeneity of practices. Several studies show that good knowledge of the disease associated with personal skills and optimal medication improve treatment compliance and decrease school absenteism and asthma exacerbations. The “Asthma School” conducted in the Children's Hospital of Lausanne, Switzerland is in keeping with these recommendations. The aim of the study was to evaluate the impact of Asthma School (therapeutic education) on the number of medical visits in asthmatic children. We also assessed the quality of life of children and their caregivers.

We included in a prospective longitudinal study every child aged 4 to 12 years and their parents attending Asthma School over 1 year and followed them at 6 months. The number of emergency visits, medical appointments, and hospitalizations during the year before and after Asthma School was assessed with a questionnaire administered to the family physicians (GPs, pediatricians). Quality of life was evaluated with the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) at inclusion and 6 months after.

Twenty-seven children and their parents were included. The mean age was 7.02 years. Pediatric visits, emergency visits, and hospitalizations decreased significantly between the year before and the year after Asthma School. Emergency visits were 41, 1 year before Asthma School and 21, 1 year after it, medical appointments were 62 vs 30, and hospitalizations were 17 vs 2, respectively. The Wilcoxon sign-rank test demonstrates a significant difference with P=0.010 for medical appointments, P=0.021 for emergency visits, and P=0.002 for hospitalizations. Quality of life in children improved in all domains but one evaluated by the PAQLQ(S) (score of 5.90 vs 6.52). Parental quality of life (PACQLQ) improved in all domains (overall score of 5.21 vs 6.15).

Interactive education on asthma improves clinically important outcomes and quality of life in children and their families. The skills acquired allow them to manage daily life.