Related Experiment Video
Updated: Mar 13, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Multidisciplinary treatment in children with problematic severe asthma: A prospective evaluation
Marieke Verkleij1,2,3, Anita Beelen2,4, Bart E van Ewijk2
1Merem Netherlands Asthma Center, Davos, Switzerland.
Insights
Intensive inpatient treatment significantly improved asthma control in children with severe, difficult-to-manage asthma. Most children experienced better asthma control and quality of life after the multidisciplinary program.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Clinical Research
Background:
- Severe asthma in children presents significant management challenges.
- Achieving adequate asthma control is often difficult for these patients.
- Multidisciplinary inpatient treatment is a potential strategy for problematic severe asthma.
Purpose of the Study:
- To evaluate the impact of intensive multidisciplinary inpatient treatment on children with problematic severe asthma.
- To assess multiple outcome variables including asthma control, lung function, and quality of life.
- To determine the effectiveness of this approach in a pediatric population.
Main Methods:
- Prospective observational study involving 89 children with problematic severe asthma.
- Evaluated outcomes including Childhood Asthma Control Test (C-ACT), FEV1, FeNO, quality of life, coping, behavioral problems, and parenting stress.
- Assessments were conducted pre-treatment, post-treatment, and at 3-6 months follow-up.
Main Results:
- Asthma control (C-ACT) improved significantly, with controlled asthma rates rising from 18% pre-treatment to 69% post-treatment.
- Significant improvements were observed in C-ACT, FeNO, quality of life, and behavioral problems post-treatment, largely maintained at follow-up.
- While asthma control improved, children's coping and parenting stress did not show significant changes.
Conclusions:
- Multidisciplinary inpatient treatment is an effective approach for children with severe asthma uncontrolled in secondary care.
- The study highlights the benefits of intensive, comprehensive care for this challenging patient group.
- Findings support the use of this treatment model for heterogeneous cases of pediatric severe asthma.
Objective:
For children with problematic severe asthma, achieving adequate control of asthma is difficult. The aim of this prospective observational study was to evaluate the effects of intensive multidisciplinary inpatient treatment on multiple outcome variables in children with problematic severe asthma.
Methods:
Participants were 89 children with problematic severe asthma (mean age 13.6 ± 2.5 years) treated in tertiary care clinics at high altitude (Switzerland) or sea level (Netherlands) and their parents (85 mothers, 55 fathers). The primary outcome variable was the Childhood Asthma Control Test (C-ACT). Other outcome variables were forced expiratory volume in 1 sec (FEV1 ), fractional concentration of exhaled nitric oxide (FeNO), quality of life [PAQLQ(S)], children's coping (UCL-A), parents' report of behavioral problems (CBCL), and parenting stress (PSI/NOSI). Evaluations were taken pre-treatment, post-treatment, and 3-6 months follow-up. Median [P25;P75] treatment duration 74 [56;80] days; Median follow-up interval 131 [103;177] days.
Results:
The percentages of children showing controlled asthma (C-ACT) were 18% (pre-treatment), 69% (post-treatment), and 44% (follow-up). The vast majority of the children (80%) showed an improvement on C-ACT with 4% showing a deterioration. On C-ACT, FeNO, quality of life, and behavioral problems, improvements at post-treatment were highly significant. Improvements generally remained at a functional level at follow-up. Children's coping and parenting stress in parents did not change.
Conclusions:
The improvement in asthma control and other outcome variables suggests that multidisciplinary inpatient treatment is an effective approach for a heterogeneous group of children with asthma that remained uncontrolled in secondary care. Pediatr Pulmonol. 2017;52:588-597. © 2016 Wiley Periodicals, Inc.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Asthma-IV: Nursing Management
First, in...