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Benefits of an education programme on the self-management of aerosol and airway clearance treatments for children with cystic fibrosis

School of Physiotherapy, Curtin University of Technology, Western Australia

C M Roberts

School of Psychology, Curtin University of Technology, Western Australia

A M Blackmorel

School of Physiotherapy, Curtin University of Technology, Western Australia

P N Le Souëf

School of Paediatrics and Child Health, University of Western Australia

S C Jenkins

Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia; Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Western Australia

Adherence to recommended aerosol medicines and airway clearance techniques (ACT) for children with cystic fibrosis (CF) requires self-management skills. A multi-centre, randomized, controlled trial was conducted to investigate the effectiveness of a self-management education programme called ‘Airways’ for six-to 11-year old children with CF and their caregivers. Assessments were conducted immediately before and after the intervention period, and six and 12 months after the post-intervention assessment. The pen and paper education programme was completed by the child and caregiver together at home. Participants in the intervention and control groups had similar baseline characteristics. A per-protocol analysis was conducted and for variables that changed significantly, an additional intention-to-treat analysis was performed that included data from participants in the intervention group who withdrew from the study during the intervention period. The intervention group increased the percentage of prescribed aerosols taken (P < 0.001) and this was maintained at 12-month follow-up (P < 0.001). There was no change in the percentage of prescribed ACT performed, although when the child was unwell, caregivers in the intervention group increased the frequency and/or duration of ACT (P = 0.028) in the perprotocol analysis but not in the intention-to-treat analysis. Children in the intervention group increased their knowledge of ACT (P < 0.001) which was maintained at 12-month follow-up (P < 0.001) and felt more positively about their chest treatment regimens immediately following the intervention (P = 0.017) but not at 12-month follow-up. There were no significant changes in the control group for these variables over time. No significant changes occurred in the caregivers' reports of self-management behaviours and self-efficacy in either group. The positive results suggest that ‘Airways’ is a valuable educational tool for primary school-aged children with CF and their caregiver.

Key Words: adherence • aerosol treatments • airway clearance techniques • cystic fibrosis • self-management

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