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Introduction of a new paediatric asthma guideline: Effects on asthma control levels

S C Hammer1, L J H Sonneveld1, K D G van de Kant1

  • 1Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|January 21, 2017
PubMed

Insights

A new paediatric asthma guideline did not improve overall asthma control in children. While step-down treatment increased for controlled asthma, uncontrolled asthma management remained unchanged.

Area of Science:

  • Pediatric Pulmonology
  • Public Health Guidelines
  • Asthma Management

Background:

  • A national paediatric asthma management guideline, based on the Global Initiative for Asthma (GINA), was implemented in the Netherlands in 2008.
  • This study aimed to evaluate the impact of this guideline on asthma control and treatment strategies in children.

Purpose of the Study:

  • To assess whether the introduction of a new national paediatric asthma management guideline improved asthma control and treatment regimens.
  • To compare asthma control and treatment patterns before and after the guideline's implementation.

Main Methods:

  • A comparative study involving two groups of children (6-16 years) with asthma, surveyed in 2004 (before) and 2013 (after) the guideline introduction.
  • Data collection included questionnaires for children, parents, and paediatricians on symptoms, medication, and healthcare use, supplemented by spirometry.

Main Results:

  • Asthma control levels did not significantly improve; the proportion of controlled asthmatics was 51% in 2004 and 59% in 2013 (p=0.28).
  • Paediatricians' assessment of control (76%) differed from GINA criteria (59%) in 2013 (p<0.05).
  • Step-down treatment for controlled asthma increased significantly (8% to 40%, p<0.05), but step-up treatment for uncontrolled asthma did not improve.

Conclusions:

  • The new paediatric asthma guideline did not lead to an improvement in overall asthma control.
  • An improvement was noted in the application of step-down treatment for children with controlled asthma following the guideline's introduction.
Abstract

Keywords:
asthmaasthma controlasthma treatmentguidelineoutpatient clinicpaediatrician

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