Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis

Area of Science:

• Pediatric Pulmonology
• Asthma Management
• Healthcare Disparities

Background:

• Limited comparative data exists on the effectiveness of multidisciplinary severe asthma clinics (SACs) versus single-discipline clinics (SDCs) for pediatric severe asthma.
• Severe asthma in children presents significant morbidity, particularly within certain demographic groups.

Purpose of the Study:

• To compare asthma outcomes between pediatric patients treated in SACs and SDCs.
• To examine the longitudinal health outcomes for severe asthma patients managed in SACs.

Main Methods:

• A retrospective cohort study compared pediatric severe asthma patients (ages 5-18) treated at a multidisciplinary SAC versus SDCs between 2018-2022.
• Primary outcome was acute healthcare utilization (hospitalizations, ED visits); secondary outcomes included systemic corticosteroid and controller medication use.
• Longitudinal outcomes (healthcare utilization, symptom control, spirometry) were assessed 12 months pre- and post-SAC enrollment.

Main Results:

• The study included 280 patients; SAC patients were more likely to be Black and have higher baseline morbidity.
• SAC enrollment was associated with significant reductions in acute exacerbations (35 to 8), hospitalizations (21 to 1), and ICU admissions (8 to 1) within 12 months.
• Significant decreases in systemic corticosteroid prescriptions and emergency department visits were also observed post-SAC enrollment.

Conclusions:

• Multidisciplinary severe asthma clinics demonstrate significant value in reducing healthcare utilization for high-risk pediatric severe asthma patients.
• Targeted, multidisciplinary care approaches are crucial for improving outcomes and managing severe asthma in vulnerable pediatric populations.
• The findings underscore the importance of addressing healthcare disparities in severe pediatric asthma management.