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The pediatric asthma yardstick: Practical recommendations for a sustained step-up in asthma therapy for children with
Bradley E Chipps1, Leonard B Bacharier2, Judith R Farrar3
1Capital Allergy & Respiratory Disease Center, Sacramento, California.
Insights
This study introduces the Pediatric Asthma Yardstick, a tool to guide clinicians on stepping up asthma therapy for children with poorly controlled symptoms. It offers practical, age-specific recommendations for effective pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Clinical Practice Guidelines
- Asthma Management
Background:
- Current asthma guidelines emphasize a control-based approach, but achieving control in children remains challenging.
- Existing tools aid daily symptom tracking, yet guidance on escalating long-term care is lacking.
- Pediatric asthma treatment is complicated by distinct age groups: adolescents (12-18), school-aged children (6-11), and young children (≤5).
Purpose of the Study:
- To introduce the Pediatric Asthma Yardstick, a tool for assessing when and how to escalate therapy for children with uncontrolled asthma.
- To provide clinicians with practical, age-stratified recommendations for stepping up asthma treatment.
- To enhance the management of pediatric asthma, especially in cases unresponsive to standard therapies.
Main Methods:
- Development of the Pediatric Asthma Yardstick based on current asthma guidance documents.
- Incorporation of newer data and clinical expertise from authors.
- Creation of patient profiles and step-up strategies tailored to different pediatric age groups.
Main Results:
- The Pediatric Asthma Yardstick offers an in-depth assessment for stepping up therapy in children with not well or poorly controlled asthma.
- Provides practical and clinically relevant recommendations for each step-up and intervention.
- Addresses age-specific treatment needs within pediatric asthma management.
Conclusions:
- The Pediatric Asthma Yardstick serves as a valuable resource for clinicians managing pediatric asthma.
- Facilitates individualized and effective treatment adjustments for children with difficult-to-control asthma.
- Aims to improve therapeutic outcomes for pediatric patients with asthma.
Abstract:
Current asthma guidelines recommend a control-based approach to management involving assessment of impairment and risk followed by implementation of treatment strategies individualized according to the patient's needs and preferences. However, for children with asthma, achieving control can be elusive. Although tools are available to help children (and families) track and manage day-to-day symptoms, when and how to implement a longer-term step-up in care is less clear. Furthermore, treatment is challenged by the 3 age groups of childhood-adolescence (12-18 years old), school age (6-11 years old), and young children (≤5 years old)-and what works for 1 age group might not be the best approach for another. The Pediatric Asthma Yardstick provides an in-depth assessment of when and how to step-up therapy for the child with not well or poorly controlled asthma. Development of this tool follows others in the Yardstick series, presenting patient profiles and step-up strategies based on current guidance documents, but modified according to newer data and the authors' combined clinical experience. The objective is to provide clinicians who treat children with asthma practical and clinically relevant recommendations for each step-up and each intervention, with the intent of helping practitioners better treat their pediatric patients with asthma, particularly those who do not always respond to recommended therapies.
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