Impact of a diagnostic therapeutic educational pathway program for asthma management in preschool children.

Bibliographic Details
Title: Impact of a diagnostic therapeutic educational pathway program for asthma management in preschool children.
Authors: Guarnaccia, Sebastiano, Quecchia, Cristina, Festa, Andrea, Magoni, Michele, Zenoni, Giuseppe, D'Agata, Emanuele, Brivio, Valentina, Zanardini, Elena, Scarcella, Carmelo, Gretter, Valeria, Facchetti, Susanna, Gasparotti, Cinzia, Pluda, Ada, Frassine, Malica, Limina, Rosa Maria, Spiazzi, Raffaele, Badolato, Raffaele, Bender, Bruce, Donato, Francesco
Source: Italian Journal of Pediatrics; 3/10/2021, Vol. 47 Issue 1, p1-7, 7p
Subject Terms: ASTHMA prevention, ASTHMA diagnosis, ASTHMA treatment, ANTIBIOTICS, ADRENERGIC beta agonists, ASTHMA, EVALUATION of human services programs, CLINICAL trials, ADRENOCORTICAL hormones, FAMILIES, PRE-tests & post-tests, MEDICAL care use, DYSPNEA, RESPIRATORY organ sounds, LEUKOTRIENE antagonists, HOSPITAL care, PATIENT education, LONGITUDINAL method, CHILDREN
Geographic Terms: ITALY
Abstract: Background: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have yet been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center. Methods: This is a retrospective population-based cohort study performed in children with asthma aged 0–5 years, attending at "Io e l'Asma center", Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention. Results: A total of 741 patients, aged 0–5 years completed the DTEP, including 391 and 350 children aged 0–2 and 3–5 years, respectively. The percentage of children aged 0–2 and 3–5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5 to 60.9% and from 25.5 to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to − 80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage. Conclusions: The results suggest that a real-world assessment of the integrated DTEP program for preschool children provides evidence for improved wheezing control and reduction of adverse therapeutic related outcomes. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
More Details
ISSN:17208424
DOI:10.1186/s13052-021-00992-y
Published in:Italian Journal of Pediatrics
Language:English