School Asthma Research Articles

The reliability and validity of the Turkish version of the school-based asthma and allergy screening questionnaires

BackgroundAsthma is an important public health disease affecting children that may result in school absenteeism and hospitalization. This study aims to assess the validity, reliability, and diagnostic accuracy of the Turkish version of the asthma and allergy screening questionnaire.MethodsThis study included primary and secondary school students from grades 2 to 7 and their parents or caregivers. For validity, 40 children with asthma and 39 children with allergies diagnosed by the questionnaire were used to determine the sensitivity. The specificity was calculated by using the data of 100 children without asthma and allergies. The study was completed with the participation of 704 students and parents. The intraclass correlation coefficient (ICC) was used to assess item reliability. Receiver operating characteristic (ROC) analysis was used to assess validity.ResultsWhen the cutoff point of the questionnaire was 2/3 for asthma, the sensitivity was 80.0% and 82.5% and the specificity was 56.6% and 76.8% according to the student and parent form, respectively. When the cutoff point of the questionnaire was 0/1 for allergies, the sensitivity was 74.4% and 84.6% and the specificity was 66.3% and 54.2% according to the student (SQ) and parent questionnaire (PQ), respectively. The reliability of test-retest correlation values (≥0.68) of asthma and allergy questionnaires were found to be statistically significant. The internal consistency Cronbach’s α values of the asthma SQ and PQ were 0.72 and 0.80, respectively.ConclusionsAccording to the Turkish questionnaire for students and their parents, the sensitivity of asthma and allergy questionnaires was similar in proportion to the original questionnaire. The Turkish version of the questionnaire can be used for asthma and allergy screening in schools.

School practices in supporting children with asthma in Malta

Objective The objective of this study was to obtain information about teachers’ knowledge, attitudes, practices and beliefs about medication related to working with children having asthma in state primary schools in Malta. This study provides information about management in a country with a high prevalence of asthma among children, and limited availability of school nurses. Methods A cross-sectional electronic survey investigating beliefs about medicines, asthma knowledge, attitude toward students with asthma, self-efficacy and practice in an asthma exacerbation, current practices, views, experiences and training relating to asthma was sent to all participating state primary schools in Malta. Results A total of 167 teachers from 26 schools answered the questionnaire. The majority of respondents (56%) were unaware of children’s conditions and limited information about children’s asthma was provided to them. Only 20% of teachers reported receiving training on how to support children with asthma. Overall, teachers reported low asthma knowledge scores (mean score of 5.5 ± 3.3 out of a possible maximum of 14), and poor self-efficacy with only 6% agreeing that they can support a student having an asthma exacerbation on their own rather than sending the student to hospital. The study also demonstrated a strong interest by teachers to receive asthma education. Conclusions Interventions with regard to identifying students with asthma, asthma training for teachers, individualized asthma action plans, enhanced communication between school staff, parents and the medical team, and standard guidelines/policy are needed to provide a supportive school environment for primary school children with asthma.

The Role of Pediatric Health-care Providers in Promoting Students' Asthma Health.

The Role of Pediatric Health-care Providers in Promoting Students' Asthma Health.

Use of the electronic nose to screen for small airway dysfunction in schoolchildren

Accurate methods that can be used to detect asymptomatic children with asthma in schools are lacking. Small airway dysfunction is a precursor of asthma. The objective of this study was to use the electronic nose (E-nose) to detect small airway dysfunction in elementary schoolchildren at risk of asthma and evaluate the acute effects of air pollution on respiration. We conducted this study in an elementary school. The study recruited 40 asymptomatic students with a history of asthma and 40 age- and sex-matched children without a history of asthma to take the breath test. We used an E-nose to analyze volatile metabolites and gas chromatography-mass spectrometry to analyze common air pollutants in exhaled breath. After excluding eight subjects in pilot tests, we included 72 subjects in the final analysis of the breath test. The sensitivity of detecting small airway dysfunction with the E-nose was 0.92, the specificity was 0.95, the positive predictive value was 0.79, the negative predictive value was 0.98, the overall accuracy was 0.94, and the leave-one-out cross-validation accuracy was 0.74. The area under the curve was 0.98 (95 % confidence interval: 0.96–1.00). Methyl tert-butyl ether was the only ambient air pollutant that had a significant negative correlation with the maximum mid-expiratory flow (r = -0.33, P < 0.05). The E-nose is highly accurate at detecting small airway dysfunction in children at high risk for asthma. An analysis of exhaled breath can also be used as a personal monitoring method to assess the acute effects of air pollution on respiration.

Enhancing family nursing practice in schools: School nurses’ perspectives on illness beliefs and family nursing practice skills when caring for children with attention-deficit hyperactivity disorder or asthma – A cross-sectional study

An increasing number of children attend schools with chronic illnesses/disorders that require managing and comprehensive healthcare from school nurses during the day. Collaboration between school nurses, the school-aged child with attention-deficit hyperactivity disorder (ADHD) or asthma, and their families is needed when coordinating/managing chronic health problems in the school setting. However, involving families in the assessment and care planning processes can be challenging. The aim of this study was to survey the illness beliefs of school nurses and their perceptions of their family nursing practice skills when offering healthcare services to children with ADHD or asthma in schools. A cross-sectional study was used for a sample of 82 school nurses. The manuscript was prepared following STROBE guidelines. Results indicated that the school nurses perceived themselves to be more confident and to have better knowledge and skill in family nursing practice when offering healthcare services to families of children with ADHD in comparison to asthma.

Effect of Buteyko Breathing Technique on Asthma Severity Control among School Age Children: Abstract Thesis

Background: Asthma is a complex condition that can impair the child’s physical growth. It affect not only the child’s physical status but also his optimal functional capacity and performance. Buteyko Breathing Technique is an exercise designed to regulate the breathing process. Aim: This study aimed to study the effect of Buteyko Breathing Technique (BBT) on asthma severity control among school age children. Materials and Methods: A quasi-experimental design (one group pre and posttest) was conducted on 33 asthmatic school age child who attended the sensitivity outpatient clinics at Mansoura University Children's Hospital (MUCH). Tools: Structured interview sheet for child and their parent, Childhood Asthma Control Test(C-ACT), Peak Expiratory Flow Rate (PEFR) and Control Pause Test (CP) are used to collect data. Results: The mean C-ACT pretest was significantly improved in the posttest with high mean percent of change of posttest than pretest, which was clinically and statically high significant. There was a statistical significant increase in the mean of PEFR and CP at the fourth week than the first one with a high significant mean percent of change. There was a significant positive decrease in the heart rate over the four weeks of follow up with high mean percent of change at fourth week than first one. Conclusion: This study support the effectiveness of BBT in improving respiratory outcome and promoting asthma control among school age children with bronchial asthma.

Strategy of adherence to long-term bronchial asthma control formation

Oneof the approaches to the formation of adherence to long-term treatment of patients with bronchial asthma, the basis of whichis the introduction of a learning factor into their therapeutic complex, is considered. The cognitive strategy of individual andgroup education of patients in the Asthma School environment helps to awaken the patient’s activity at the level of competencein the management of the illness, and cooperation with the attending physician. The patient consistently acquires the necessaryknowledge, useful skills and confidence in the importance of personal participation in the treatment of this disease, movingfromcompliance to informed adherence to treatment. The significant advantages of long-term treatment of bronchial asthma,in which trained patients are involved, are shown.

Improving Rates of Timely Completion of School Asthma Medication Administration Forms Using Data From the Electronic Health Record

Improving Rates of Timely Completion of School Asthma Medication Administration Forms Using Data From the Electronic Health Record

Asthma Prevalence and Mold Levels in US Northeastern Schools

Asthma is among the most common chronic diseases of children in the United States (US). Mold exposures have been linked to asthma development and exacerbation. In homes, mold exposures have been quantified using the Environmental Relative Moldiness Index (ERMI) and higher home ERMI values have been linked to occupant asthma. In this analysis of the School Inner-City Asthma Study 2 (SICAS 2), we aimed to evaluate the ERMI’s applicability to measuring mold in schools compared to homes, to assess the relationship between the prevalence of asthma in schools and mold levels, and to examine the prevalence of asthma in relationship to students’ demographics and the physical characteristics of school-buildings. Northeastern US schools (n=32) and homes (n=33) were selected and the 36-ERMI molds were quantified in a dust sample from each classroom or home. School building characteristics, student demographics and asthma prevalence data were collected from the SICAS 2 study or obtained from government websites. Linear regression and mixed models were fit to assess the association of current asthma prevalence and physical characteristics of the school, make-up of the student body and the ERMI metric. Levels of outdoor Group 2 molds were significantly (p<0.01) greater in schools compared to homes and higher Group 2 levels in schools were linked to higher asthma prevalence for their students. The presence of AC in school buildings correlated significantly (p=0.02) with lower asthma prevalence. Higher mold levels in northeastern US schools were associated with an increase in students’ asthma.

Managing Chronic Health Needs in Child Care and Schools—Asthma

Patient Education| 2021 Managing Chronic Health Needs in Child Care and Schools—Asthma Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Managing Chronic Health Needs in Child Care and Schools—Asthma. Pediatric Patient Education 2021; 10.1542/ppe_document008 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Managing Chronic Health Needs in Child Care Asthma is a chronic long-term condition that causes air passages to the lungs to become inflamed, swollen, and narrowed. The swelling can narrow passages enough to reduce or block airflow to and from the lungs. As air moves through the narrowed airway, it can make a wheezing sound.Children with asthma may have repeated episodes of wheezing, coughing, breathlessness, and chest tightness with nighttime or early morning coughing. Asthma is one of the most common chronic diseases in children, affecting between 5% and 10% of children in the United States. Asthma can vary from mild to severe, and it can be occasional or continuous.Asthma can worsen with infections, with weather changes, and with exposure to an asthma trigger. Asthma triggers are things that worsen asthma. Common triggers include viral infections, smoke, dust, mold, dust mites, cockroaches, and animal dander.Children... © 2019 American Academy of Pediatrics. All rights reserved. You do not currently have access to this content.

Attributing School Air Pollution Levels to Features of the Built Environment in New York City

Background: Exposure to traffic-related air pollution (TRAP) has been linked to asthma prevalence and exacerbations. Children spend a significant portion of their day in school where exposure to pollutants can be high based on geographic features of the built environment. The study objective was to determine the distributions of geographic indicators of traffic and built environment features and the association with school-based TRAP exposure in New York City (NYC).Methods: Spatial data on the proximity and density of roadways and built environment features were examined for a 250-meter buffer around NYC elementary and middle schools (N=1184). Annual average levels of particulate matter &lt;2.5 microns (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) were determined based on land use regression models of street-level pollution measured by the New York City Community Air Survey. Spatial data were categorized using k-means cluster analysis and clusters were associated with air pollution using analysis of variance.Results: Based on significant correlations with air pollutants, three geographic indicators were included for cluster analysis: number of bus stops; truck route density (total km route/km2 land); and percentage of area covered with trees (i.e. tree canopy). Four clusters were identified: 1. Higher truck route density (n=103 schools); 2. Higher number of bus stops (n=378); 3. Higher tree canopy (n=250); and 4. Lower in all 3 indicators (n=453). In general, the levels of PM2.5, BC, and NO2 were highest among schools with higher truck route density, followed by higher number of bus stops, and lowest with higher tree canopy (p=0.001).Conclusions: School-aged children may experience higher levels of air pollution based on their school’s proximity to geographic indicators of diesel vehicle emission. Geographic indicators may serve as surrogates of chronic school exposure to air pollution. Future studies will determine if clusters are associated with school asthma prevalence.

STUDENT ASTHMA STATUS AND SCHOOL ABSENCE

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To examine the association of student asthma status and student absences for students enrolled in first through twelfth grade in an urban school district. METHODS: A retrospective study was conducted using 112,694 students demographic and absence records for the 2010–17 academic school years for students enrolled. The school district created the data for district and state mandatory reporting. The student asthma status was based upon the student record containing an asthma action plan (AAP) that was signed by a licensed healthcare provider. The student absence was based on the attendance record for each student each day of each year. The number of absence records for each student is the number of days a student was coded as absent. Characteristics of the student included gender, race, ethnicity, socioeconomic status and grade. The main outcome of this study was school absence and all descriptive data are stratified by asthma status. To determine any major differences by year, all data was analyzed separately. The absence data is reported by number of cumulative days of school absence in categories; the proportion of students having missed at least one day of school, and only among students who missed at least one day of school. RESULTS: Because the data is consistent across the study period only 2016–17 results are reported.The population was mostly boys (51.2%) of white race (71.6%), of Hispanic/Latino ethnicity (58,7%) and from low income homes (50.1%). Asthma prevalence was 6.7% with higher proportions of asthma in boys (7.3%), among Blacks (10.1%), among students of non-Hispanic/Latino ethnicity (6.9%), and among students from low income homes (13.3%), among those who missed at least one day of school (7.1%) and especially among students who had missed 18 or more days (10.1%). Overall majority of students (90.0%) missed one day of school, with a median number of absent days of 6 days (p25=3, p75=10). Of students who missed at least one day, the proportion was higher in girls (90.2%), among American Indians or Alaskan Natives (91.2%), Of students who missed at least one day, the proportion of students with asthma (94.1%) was higher than those without asthma (89.7%). Students with asthma missed a median of seven days (p25=4; p75=13). Students with asthma missed a higher proportion of 18 or more days (13.6% vs.9.1%) compared to students without asthma. CONCLUSIONS: Although 90% of all students missed at least one day of school, a higher proportion of students were identified as having asthma and from a low income income homes, and missed more days of school. CLINICAL IMPLICATIONS: Asthma disease management strategies are needed for students that are boys, Black, non-Hispanic/Latino and from low income homes to improve school absences. DISCLOSURES: No relevant relationships by Jose Betancourt, source=Web Response No relevant relationships by De De Gardner, source=Web Response

Developing a theory-based multimedia intervention for schools to improve young people\u2019s asthma: my asthma in school (MAIS)

BackgroundAsthma control in adolescents is low with half of the young people in a London study identified as having suboptimal control when measured using the Asthma Control Test. Control of asthma symptoms can be improved by addressing barriers to good self-management, such as poor understanding of asthma and adherence to medication. The aim of this study was therefore to develop the My Asthma in School (MAIS) intervention for the improvement of asthma control and self-management in adolescents and to test its initial feasibility. The intervention intended to combine a strong focus on theory with a design specifically aimed to engage adolescents.MethodsThe intervention development was based on previous qualitative and quantitative findings, and on guidelines from the Medical Research Council for the development of complex interventions. The COM-B (Capability, Opportunity, Motivation–Behaviour) model was applied to inform the design of intervention elements. Behavioural targets were identified from existing barriers to good asthma self-management and were then used to guide the development of engaging intervention elements, which were described using the Behavioural Change Technique (BCT) Taxonomy version 1. Adolescents were involved throughout this process. The MAIS intervention was tested in a feasibility phase in London secondary schools with adolescents aged between 11 and 13.ResultsThe complex school-based MAIS intervention comprised a first school visit from a theatre group, who conducted a workshop with all year 7–8 students and addressed peer understanding and attitudes to asthma. The second visit included four self-management workshops for adolescents with asthma, including games, short-films and role play activities. Forty different types of techniques to change behaviour were applied, totalling 163 instances of BCT use across intervention elements, addressing all areas of capability, opportunity and motivation. In this initial feasibility study, 1814 adolescents with and without asthma from nine schools received the theatre intervention visit; 23 adolescents with asthma from one of the schools attended the workshop visit. The intervention was found acceptable and engaging, and 91.4% of participants agreed that the workshops changed how they think or feel about asthma.ConclusionThis study demonstrates development and initial feasibility of a complex theory-based intervention, and how it can combine engaging media and interactive elements, to achieve a multi-directional approach to behavioural change. However more work is needed to assess the feasibility of trial processes, including recruitment and delivery format of the workshops.

Nursing interventions for School Age Children with Bronchial Asthma in a Rural Area

Background: Bronchial asthma is one of the most common chronic diseases among children and adolescents. In recent decades, the prevalence of asthma and morbidity are increasing. It is a common cause of school absenteeism and limitation of activity in children. Aim: the study aimed to evaluate nursing interventions for school age children with bronchial asthma in a rural area. Subject and Methods: The study was conducted at primary school in rural area in Saft El- Laban El Giza governorate. Sample: Multi stage random sample technique (76) asthmatic children were selected. Tools: (1) child health record (2) self administer questionnaire (3) observation checklists. Results: as predisposing factors, majority (more than four third) of them had of previous problem related to respiratory system, more than half of study sample exposed to father smoking, 96.1% of asthmatic children had oil painted on their walls more than half of them had animals inside their home and majority (more than four third) had suffered from mosquitoes inside the house more than three third of school class had Poor ventilation and four third of class had blackboard and Study sample had improved total knowledge of asthma near one third, more than three third, about four third pre, post, and follow up respectively. Conclusion: there were improved the knowledge and practices of asthmatic children after nursing intervention program. Recommendations: the study recommended establish plan for periodical health educational program for asthmatic school children and their mothers to be conducted in inpatient, emergency department and outpatient clinics.

Dissemination of Evidence-Based School Asthma Management Programs: Piloting Asthma 411 in an Urban Texas School District.

The dissemination and implementation (D&I) of evidence-based initiative (EBIs) is critical to improved public health. The Asthma 411 EBI was piloted in Texas from 2013 to 2015. The pilot's evaluation assessed its effectiveness and identified approaches to support D&I of school-health EBIs. The pilot study was conducted in two schools; service categories included: a consulting physician, enhanced school asthma services, and support for links to community health resources. Data was collected on Emergency Medical Service (EMS) calls, aggregated nursing services, demographic characteristics, availability of medication provided through existing policies, and informal interviews. During the pilot, school-day asthma-related Emergency Medical Service (EMS) calls were eliminated. Documented asthma self-management education, authorization for rescue medication, and efforts to communicate with parents and health providers increased. Between year-1 and year-2, the gap between unadjusted, weighted mean absences among students with and without asthma was reduced by 1.1 days. However, this difference was not seen in a fully adjusted negative, binomial regression model. Evaluation of the Asthma 411 pilot suggests many EBI benefits were retained and identifies factors that may facilitate D&I of school health EBIs. Future research will clarify impacts on absenteeism and determine if observed benefits are sustained.

Impact of obesity on asthma severity and control in school aged children

Background:Childhood asthma and obesity are significant public health problems. The prevalence of asthma and obesity in children have increased significantly during the past decades. The basis for the relationship between pediatric asthma and obesity is not well established. Objective: our study aimed to find the relation between obesity and bronchial asthma and whether obesity may contribute to more severe asthma symptoms in asthmatic children at Qena University Hospital. Patients and method(s): This was a cross-sectionalstudy of asthmatic school aged children who were admitted at pediatric department or attendedemergency department or the outpatient clinic of Qena University Hospital through the period from MAY 2018 to April 2019.They classified according to BMI to two groups, asthmatic obese and asthmatic non-obese. The included asthmatic children are subjected to full through history, clinical examination and pulmonary function tests. Result(s):This was a cross-sectional study which was carried out in Pediatric department of Qena university hospitaland included 60 asthmatic children with intermittent to severe persistent asthma with age range 6-12 years through the period from MAY 2018 to April 2019 and classified to two groups, 30cases asthmatic obese and 30 cases asthmatic non-obese, based on calculated BMI in both groups. The patients were diagnosed according to the global strategy for asthma management and prevention classification. The mean age in asthmatic obese patients was (8.94±1.99)versus (9.13±1.97) in asthmatic non-obese group with no significant difference between them (p-value =0.707). The percentage of moderate persistent asthma was statistically significantly higher in asthmatic obese than asthmatic non-obese group (53.3% versus 26.7%, p-value= 0.035), respectively. 13.3% of asthmatic obese had severe persistent asthma versus 0% in asthmatic non-obese group (p-value=0.038).46.7%of the asthmatic obese children received high dose of steroids versus 10%of asthmatic non-obese with statistically significant difference (p value =0.001). The mean numbers of emergency visits in asthmatic obese were significantly higher than that in asthmatic non-obese (5.9±2.66versus 3.93±1.6), (p-value= 0.001), respectively. FEV1, FVC, FEV1/FVC, were not significantly different in asthmatic obese patients compared with asthmatic non-obese (p-value =0.742, 0.849, 0.751, respectively). Conclusion:obesity was associated with significantly more severe asthma symptoms together with poor asthma control. Pulmonary function tests were not affected by increased BMI.

Maximizing the Role of the Nurse: Strategies to Address Gaps in Asthma Care in Schools

PurposeThe purpose of this project was to describe differences in the numbers of children with a diagnosis of asthma identified through two methods, determine barriers to receiving asthma interventions in elementary school settings, and make recommendations for action and advocacy for school nurses to increase the number of children with access to asthma medications at school. Design and methodsThe authors conducted a review of the asthma diagnosis process from the initial identification of a diagnosis to the delivery of interventions with 349 enrolled students in one large, urban public school in Tennessee. ResultsSixty children were identified using the school's existing parent identification process and 91 children who participated in a concurrent asthma education program self-identified or were referred by a teacher, staff, or administrator. Only seven students identified through the combined methods had access to asthma medication (albuterol) at school. ConclusionMissing asthma action plans, medication forms and inhalers emerged as major barriers to intervention even when a child's diagnosis is documented. Practice implicationsThe Asthma School Readiness Process (ASRP) was developed, which describes recommendations for nurses in school and community settings to promote safety and access to asthma medication in schools.

Asthma and subsequent school performance at age 15\u201316 years: A Swedish population-based sibling control study

Asthma may negatively affect children’s school performance, such as grades and exam results. Results from previous studies have shown varying results and may have suffered from confounding and other biases. We used a Swedish population-based cohort of 570,595 children with data on asthma (including severity and control) in Grades 7–8 and 9, school performance from Grade 9 (grade point sum, non-eligibility for upper secondary school and national test results) and measured confounders from national registers. We used sibling comparisons to account for unmeasured familial factors. Children with asthma and severe asthma performed slightly better in school than children without asthma when adjusting for measured confounders, but the associations were attenuated in sibling comparisons. In contrast, children with uncontrolled asthma performed slightly worse (e.g. Grade 9: βadj = −9.9; 95% CI −12.8 to −7.0; Cohen’s d = 0.16). This association remained for uncontrolled asthma in Grade 9 in sibling comparisons (Grade 9: β = −7.7 points; 95% CI −12.6 to −2.6; Cohen’s d = 0.12), but not for Grades 7–8. The attenuation of estimates when controlling for familial factors using sibling comparisons suggests that the differences were due to familial factors, rather than being causal. The remaining associations in sibling comparisons between uncontrolled asthma in Grade 9 and school performance are consistent with a causal association.

PRS8 IMPLEMENTING AN ASTHMA DATATHON TO LEVERAGE PUBLIC DATA TO INFORM DECISION AND POLICY-MAKERS IN BRAZIL

to integrate and analyze public datasets to create interactive vizualizations of asthma-related outcomes, through an online open data analytics competition-datathon. A 2-day design-thinking workshop was organized by GSK in partnership with Eretz.bio (startup incubator) from Hospital Israelita Albert Einstein, to define the datathon challenge, rules, timelines and prizes. The theme was to understand the impact of diagnosis, hospitalizations, costs, mortality, structural, social and environmental factors related to asthma in Brazil. An open online call was made to invite teams to develop their projects in 2 weeks. Each team with 3 members had to use at least one database from the Public Health system (DATASUS). The evaluation criteria included: creativity and innovation in epidemiological analysis; technical capability and methodology; quality of dashboards and its visualization. Each criteria was graded from 0 to 5 by an independent judging panel, and the top 3 scores were the winners. There were 240 participants (80 teams) from 15 Brazilian States. Among them, 85% were male and regarding the background, 45% were data scientist, 24% undergraduate students, 18% healthcare professionals, 11% investigators and 2% designers. Novel analytical dashboards included interactive maps and tables describing trends of asthma hospitalizations per day/month in different regions, days of school missed last year due to asthma in school; comparison of asthma to other chronic diseases like diabetes, demonstrating similar impact on costs and resource use. These dashboards were deemed useful for public health administrators at different levels. There was consistency in the analyses of the top teams which provided insights and deeper understanding of the impact of asthma and its multiple effects. Public healthcare databases are increasing, offering the opportunity to generate evidence for decision makers. Countries with open datasets should consider implementing similar activities to increase understanding of healthcare conditions and support decision making.

A RESPONSIBLE PATIENT: FROM THEORY TO PRACTICE ON A MODEL OF A PATIENT WITH BRONCHIAL ASTHMA

Introduction: The medicine of today is focused on personalized aid to a patient, which involves partnership and mutual responsibility between the patient and the doctor. In our reality, the patient believes that the responsibility for the treatment and outcome depends on the doctor in most cases. The aim: Induce the patient to develop responsibility for the course of asthma against the background of EBW or obesity and introducing this program into the practice of family physicians. Materials and methods: By design, the study included 75 patients with asthma with varying degrees of severity, persistent course in the remission stage against the background of EBW or obesity. According to the randomization method, the patients were divided into 3 groups: the main group - 30 patients (the use of medication), the comparison group - 30 patients (training in the "Asthma School"), the 3rd group was controls of 15 patients (basic therapy). Results: According to the anthropometric study, 75 patients enrolled in the study were found to have EBW or obesity and the mean BMI was 31.67 ± 0.53 kg / m2. It was also found that 20 (66.67%) patients in the main group and 21 (70.00%) patients in the comparison group did not regularly use basic therapy and cancelled or changed the drugs without permission. After the training, 45 patients (76.66%) of the total patients of the main group and the comparison group began to perform respiratory movements with the inhalation device correctly. patients in the main group reduced body weight on an average by 4.5 kg, and BMI from 32.00 kg / m2 changed to 29.7 kg / m2 (p <0.05), although they did not reach 25.0 kg / m2 of the target level because the follow-up period was not long. Conclusion: Only patients in the main group had significant positive changes in asthma control, the patients in the comparison group also had positive dynamics, but it did not show statistically significant differences. The doctor should be interested in the fact that at the first and subsequent visits regarding the disease, in our case it is bronchial asthma, the patient will feel responsible for the disease. Therefore, when communicating with the patient, the physician should focus on this, provide the most complete answers to the patient's questions, provide educational literature and, if necessary, diaries of self-control.