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Published on: November 4, 2010
Impact of a Multidisciplinary Program in the Categorization and Management of Children With Severe Asthma
Alvaro Teijeiro1, Silvia Gómez1, Andrés Grenat2,3
1Departamento de Neumonologia, Hospital Pediátrico de Córdoba, Córdoba, Argentina.
Insights
A multidisciplinary team approach improved outcomes for children with severe asthma in Argentina. This model effectively managed difficult-to-treat asthma cases, showing significant symptom and quality of life improvements.
Area of Science:
- Pediatric Pulmonology
- Clinical Medicine
- Healthcare Management
Background:
- Severe asthma affects 5%-7% of children globally, posing a significant disease burden.
- Characterizing severe pediatric asthma in diverse healthcare settings is crucial for effective management.
Purpose of the Study:
- To describe severe asthma patient characteristics in Argentina.
- To evaluate the effectiveness of a multidisciplinary team (MDT) approach for pediatric severe asthma management.
Main Methods:
- Prospective, observational, longitudinal study conducted over 6 months.
- Involved 53 children aged 5-15 years diagnosed with severe asthma.
- Utilized a multidisciplinary team (MDT) approach for clinical management.
Main Results:
- 66% of treated patients were no longer classified as severe asthma post-program.
- Significant improvements observed in asthma symptoms, quality of life, and reduced exacerbations.
- Associated factors included allergic rhinitis (77%) and adverse psychosocial factors (47%).
- Elevated blood eosinophil counts (median 320 cells/µL) and total IgE (median 313 UI/ml) were noted.
Conclusions:
- The multidisciplinary approach demonstrated positive outcomes for most severe pediatric asthma patients.
- This model is potentially adaptable to other low-resource healthcare settings.
- Effective management of difficult-to-treat and severe therapy-resistant asthma (STRA) was achieved.
Background:
Asthma is an important global healthcare problem, and severe asthma affects 5%-7% of children with asthma. This small percentage results in a heavy burden of disease.
Objectives:
To describe the characteristics of severe asthma patients in Argentina and their evolution over time, and to evaluate the effectiveness of a multidisciplinary team (MDT) approach in the clinical management of these children.
Methods:
Prospective, observational, longitudinal study in an Argentinian Pulmonology Service.
Results:
Fifty-three children aged 5-15 years old diagnosed with severe asthma were studied over a period of 6 months; 40/53 (76%) patients were unable to access therapy (WHO Group 1) and 27/40 were finally categorized as patients with difficult-to-treat asthma after completing the program. The remaining 13 patients in Group 1 who were non-responders were classified as severe therapy-resistant asthma (STRA). Of the 13 patients who were not initially in Group 1, 8/13 were responders who no longer had severe asthma and were thus classified as difficult-to-treat asthma and the remaining five had STRA; thus 35/53 (66%) of the treated patients were no longer classified as severe asthma after completing the program. We identified adverse psychosocial factors identified in 47%. 77% had allergic rhinitis. Most had normal spirometry. Blood eosinophil count was median of 320 cell/µL, and median total IgE was 313 UI/ml. During the program, asthma symptoms, quality of life and asthma exacerbations all improved significantly.
Conclusion:
Our multidisciplinary approach was associated with better outcomes in most patients with severe asthma. This model could profitably be adopted in other low-resource settings.
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