Educating Asthmatic Children in European Ambulatory Pediatrics: Facts and Insights.

Marie Noëlle Robberecht,Marilena Moretto,Laura Reali,Elke Jäger-Roman,Antoine Deschildre,Abolfazl Najaf-Zadeh,Alain Martinot,Valérie Hue,Vesna Plevnik-Vodušek,Dominique Deplanque,Sigurlaug Agustsson,Laurent Beghin,Emile Tockert

doi:10.1371/journal.pone.0129198

Abstract

The aim of this study was to assess the role of European ambulatory pediatricians in caring for asthmatic children, especially in terms of their therapeutic education. We developed a survey that was observational, declarative, retrospective and anonymous in nature. 436 ambulatory pediatricians in Belgium, France, Germany, Italy, Luxembourg and Slovenia were asked to participate in the survey providing information on three children over 6 years old suffering from persistent asthma, who had been followed for at least 6 months. We considered the pediatricians’ profile, and their role in the therapeutic education of children. 277 pediatricians (64%) responded: 81% were primary care pediatricians; 46% participated in networks; 4% had specific training in Therapeutic Patient Education; 69% followed more than 5 asthmatic children per month, and over long periods (7 ± 4 years). The profiles of 684 children were assessed. Answers diverged concerning the provision of a Personalized Action Plan (60–88%), training the child to measure and interpret his Peak Expiratory Flow (31–99%), and the prescription of pulmonary function tests during the follow-up programme of consultations (62–97%). Answers converged on pediatricians’ perception of their role in teaching children about their condition and its treatment (99%), about inhalation techniques (96%), and in improving the children’s ability to take preventive measures when faced with risk situations (97%). This study highlights the role of European pediatricians in caring for asthmatic children, and their lack of training in Therapeutic Patient Education. Programmes and tools are required in order to train ambulatory pediatricians in Therapeutic Patient Education, and such resources should be integrated into primary health care, and harmonized at the European level.

Highlights

Asthma is the most common chronic illness in children in the European Union, with 10–12% of children affected [1]
Pediatricians participating in this study provided verbal consent to the research working group of the European Confederation of Primary Care Pediatricians (ECPCP), verbal consent was centralised at the level of each country ECPCP representative
Networking pediatricians provided a Personalised Action Plan” (PAP) more often than non-networking pediatricians (83% vs 76%, Odds ratios (OR) = 1.6; 95% confidence intervals (CI):1.1–2.5)

Summary

Introduction

Asthma is the most common chronic illness in children in the European Union, with 10–12% of children affected [1]. Asthma diminishes the quality of life of the child and his family [2]. Pediatricians have had guidelines proposed by academic societies for dealing with asthma [5,6,7,8,9,10], including the therapeutic education of children. The concept of Therapeutic Patient Education (TPE) was defined in a World Health Organization report published in 1998: the aim of this pedagogical initiative is “to help patients and their families to acquire or maintain the competencies that they need to live with a chronic illness” [11]

Objectives

Methods

Results

Conclusion