The implementation of pediatric asthma guidelines including self-assessment of the level of confidence and accessibility of medical supplies necessary for asthma management from the perspectives of multidisciplinary care teams.

Abstract

Asthma control in Thai children is not yet satisfactory. Direct observation of the clinical practice for health care professionals (HCPs) in asthma clinic is essential. To ascertain the implementation of asthma guidelines for Thai children, to assess the confidence level in general asthma management, and to determine the availability of medical supplies. A cross-sectional study was conducted in which HCPs were surveyed by questionnaire. The selection of pediatric asthma guidelines and self-assessment of their confidence level of their own asthma practice were assessed by using a score range between 1 (the lowest) and 10 (the highest). Reasons for low confidence were identified. The necessity and availability of medical supplies for asthma and its comorbidities were investigated in government hospitals in Chachoengsao province. A total of 245 participants from 11 hospitals were enrolled. There were registered nurses (38.0%), medical and nursing students (31.4%), physicians (28.2%), and pharmacists (2.4%). The Global Initiative for Asthma has been the most frequently used guideline followed by the Thai Asthma Guideline for Children 2015-2016 (56.3% vs. 52.7%; p = 0.45). The pathway for assessment and stepwise approach for adjusting treatment was the most regularly applied (61.4%). The mean overall level of confidence was 5.72 & 1.70-a moderate level. Only 2 of 11 (18.2%) surveyed hospitals had nebulized corticosteroids, and less than half of them (45.5%) had an allergic rhinitis checklist. To perfectly implement the national asthma guidelines, HCPs should be able to increase the level of confidence and procure necessary medical supplies.