Abstract
Background: Limited evidence exists for the effectiveness of educational programs that improve pediatric asthma control in real-world settings. We aimed to assess the impact of a diagnostic, therapeutic, and educational pathway (DTEP) for asthma management in children and adolescents attending an asthma referral center.Methods: This is a retrospective population-based cohort study, including two groups of patients with asthma, aged 6–17 years and residing in the Local Health Authority (LHA) of Brescia, Italy: (a) the children who followed a DTEP (intervention group) and (b) all the children residing in the LHA who did not follow DTEP (control group). The incidence rates (IRs) of hospitalization, emergency room visit, use of outpatient services, and drug prescription for dyspnea, wheezing, or respiratory symptoms were computed for time before and after attending DTEP in the intervention group and for “early” and “late” time since asthma diagnosis in the control group.Results: There were 9,191 patients included in the study, 804 of whom followed DTEP. In the before-DTEP/early time, the intervention and control groups showed similar IRs for all the outcomes apart from emergency room visits (IRs of 138.6 and 60.3 per 1,000 person-years, respectively). The IRs decreased from before to after DTEP and from early to late time in both groups. The IR decrease for emergency room visits was significantly higher in the intervention than in the control group (−51.3 and −28.2%, respectively; IRR = 0.61, P = 0.001).Conclusion: The DTEP can increase patients' capability in managing asthma and preventing asthma attacks.
Highlights
Asthma is the most common chronic disease among children
The incidence rates (IRs) decrease for emergency room visits was significantly higher in the intervention than in the control group (−51.3 and −28.2%, respectively; incident rate ratios (IRRs) = 0.61, P = 0.001)
Future risk of poor asthma outcomes domain includes preventing severe asthma attack, loss of lung function, and adverse effects caused by medication use [1,2,3]
Summary
Childhood asthma is usually defined as a heterogeneous disease, usually characterized by chronic airway inflammation It is defined as an umbrella syndrome, with symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and in intensity, together with variable expiratory airflow limitation [1,2,3]. The long-term goals of asthma management are to achieve symptom control, to minimize future risk of asthma attacks and airflow limitation, to preserve lung function, and to reduce the risk of adverse effects of treatment [1]. Future risk of poor asthma outcomes domain includes preventing severe asthma attack, loss of lung function, and adverse effects caused by medication use [1,2,3]. We aimed to assess the impact of a diagnostic, therapeutic, and educational pathway (DTEP) for asthma management in children and adolescents attending an asthma referral center
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