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

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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]
Copyright of Italian Journal of Pediatrics is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Impact of a diagnostic therapeutic educational pathway program for asthma management in preschool children.
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  Data: <searchLink fieldCode="AR" term="%22Guarnaccia%2C+Sebastiano%22">Guarnaccia, Sebastiano</searchLink><br /><searchLink fieldCode="AR" term="%22Quecchia%2C+Cristina%22">Quecchia, Cristina</searchLink><br /><searchLink fieldCode="AR" term="%22Festa%2C+Andrea%22">Festa, Andrea</searchLink><br /><searchLink fieldCode="AR" term="%22Magoni%2C+Michele%22">Magoni, Michele</searchLink><br /><searchLink fieldCode="AR" term="%22Zenoni%2C+Giuseppe%22">Zenoni, Giuseppe</searchLink><br /><searchLink fieldCode="AR" term="%22D'Agata%2C+Emanuele%22">D'Agata, Emanuele</searchLink><br /><searchLink fieldCode="AR" term="%22Brivio%2C+Valentina%22">Brivio, Valentina</searchLink><br /><searchLink fieldCode="AR" term="%22Zanardini%2C+Elena%22">Zanardini, Elena</searchLink><br /><searchLink fieldCode="AR" term="%22Scarcella%2C+Carmelo%22">Scarcella, Carmelo</searchLink><br /><searchLink fieldCode="AR" term="%22Gretter%2C+Valeria%22">Gretter, Valeria</searchLink><br /><searchLink fieldCode="AR" term="%22Facchetti%2C+Susanna%22">Facchetti, Susanna</searchLink><br /><searchLink fieldCode="AR" term="%22Gasparotti%2C+Cinzia%22">Gasparotti, Cinzia</searchLink><br /><searchLink fieldCode="AR" term="%22Pluda%2C+Ada%22">Pluda, Ada</searchLink><br /><searchLink fieldCode="AR" term="%22Frassine%2C+Malica%22">Frassine, Malica</searchLink><br /><searchLink fieldCode="AR" term="%22Limina%2C+Rosa+Maria%22">Limina, Rosa Maria</searchLink><br /><searchLink fieldCode="AR" term="%22Spiazzi%2C+Raffaele%22">Spiazzi, Raffaele</searchLink><br /><searchLink fieldCode="AR" term="%22Badolato%2C+Raffaele%22">Badolato, Raffaele</searchLink><br /><searchLink fieldCode="AR" term="%22Bender%2C+Bruce%22">Bender, Bruce</searchLink><br /><searchLink fieldCode="AR" term="%22Donato%2C+Francesco%22">Donato, Francesco</searchLink>
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  Data: Italian Journal of Pediatrics; 3/10/2021, Vol. 47 Issue 1, p1-7, 7p
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  Data: <searchLink fieldCode="DE" term="%22ASTHMA+prevention%22">ASTHMA prevention</searchLink><br /><searchLink fieldCode="DE" term="%22ASTHMA+diagnosis%22">ASTHMA diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22ASTHMA+treatment%22">ASTHMA treatment</searchLink><br /><searchLink fieldCode="DE" term="%22ANTIBIOTICS%22">ANTIBIOTICS</searchLink><br /><searchLink fieldCode="DE" term="%22ADRENERGIC+beta+agonists%22">ADRENERGIC beta agonists</searchLink><br /><searchLink fieldCode="DE" term="%22ASTHMA%22">ASTHMA</searchLink><br /><searchLink fieldCode="DE" term="%22EVALUATION+of+human+services+programs%22">EVALUATION of human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22CLINICAL+trials%22">CLINICAL trials</searchLink><br /><searchLink fieldCode="DE" term="%22ADRENOCORTICAL+hormones%22">ADRENOCORTICAL hormones</searchLink><br /><searchLink fieldCode="DE" term="%22FAMILIES%22">FAMILIES</searchLink><br /><searchLink fieldCode="DE" term="%22PRE-tests+%26+post-tests%22">PRE-tests & post-tests</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+care+use%22">MEDICAL care use</searchLink><br /><searchLink fieldCode="DE" term="%22DYSPNEA%22">DYSPNEA</searchLink><br /><searchLink fieldCode="DE" term="%22RESPIRATORY+organ+sounds%22">RESPIRATORY organ sounds</searchLink><br /><searchLink fieldCode="DE" term="%22LEUKOTRIENE+antagonists%22">LEUKOTRIENE antagonists</searchLink><br /><searchLink fieldCode="DE" term="%22HOSPITAL+care%22">HOSPITAL care</searchLink><br /><searchLink fieldCode="DE" term="%22PATIENT+education%22">PATIENT education</searchLink><br /><searchLink fieldCode="DE" term="%22LONGITUDINAL+method%22">LONGITUDINAL method</searchLink><br /><searchLink fieldCode="DE" term="%22CHILDREN%22">CHILDREN</searchLink>
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Italian Journal of Pediatrics is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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