Change in Approach and Delivery of Medical Care in Children With Asthma: Results From a Multicenter Emergency Department Educational Asthma Management Program

PEDIATRICS ◽  
2006 ◽  
Vol 117 (Supplement 2) ◽  
pp. S145-S151 ◽  
Author(s):  
Rodney B. Boychuk ◽  
Charles J. DeMesa ◽  
Kristi M. Kiyabu ◽  
Franklin Yamamoto ◽  
Loren G. Yamamoto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Care ◽  
Asthma Management ◽  
Management Program ◽  
Children With Asthma ◽  
Delivery Of Medical Care

scholarly journals Impact of an asthma management program on hospitalizations and emergency department visits

2011 ◽  
Vol 87 (5) ◽  
pp. 412-8 ◽  
Author(s):  
Maria J. F. Fontes ◽  
Alessandra G. A. Affonso ◽  
Geralda M. C. Calazans ◽  
Cláudia R. de Andrade ◽  
Laura M. L. B. F. Lasmar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Asthma Management ◽  
Management Program ◽  
Emergency Department Visits

scholarly journals Pharmacometabolomics of Bronchodilator Response in Asthma and the Role of Age-Metabolite Interactions

Metabolites ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. 179 ◽  
Author(s):  
Rachel S. Kelly ◽  
Joanne E. Sordillo ◽  
Sharon M. Lutz ◽  
Lydiana Avila ◽  
Manuel Soto-Quiros ◽  
...  
Keyword(s):  
Asthma Management ◽  
Management Program ◽  
P Value ◽  
Bronchodilator Response ◽  
Age Related ◽  
Children With Asthma ◽  
The Mean ◽  
Interaction With Age ◽  
Effect Of Age

The role of metabolism in modifying age-related differential responses to asthma medications is insufficiently understood. The objective of this study was to determine the role of the metabolome in modifying the effect of age on bronchodilator response (BDR) in individuals with asthma. We used longitudinal measures of BDR and plasma metabolomic profiling in 565 children with asthma from the Childhood Asthma Management Program (CAMP) to identify age by metabolite interactions on BDR. The mean ages at the three studied time-points across 16 years of follow-up in CAMP were 8.8, 12.8, and 16.8 years; the mean BDRs were 11%, 9% and 8%, respectively. Of 501 identified metabolites, 39 (7.8%) demonstrated a significant interaction with age on BDR (p-value < 0.05). We were able to validate two significant interactions in 320 children with asthma from the Genetics of Asthma in Costa Rica Study; 2-hydroxyglutarate, a compound involved in butanoate metabolism (interaction; CAMP: β = −0.004, p = 1.8 × 10−4; GACRS: β = −0.015, p = 0.018), and a cholesterol ester; CE C18:1 (CAMP: β = 0.005, p = 0.006; GACRS: β = 0.023, p = 0.041) Five additional metabolites had a p-value < 0.1 in GACRS, including Gammaminobutyric acid (GABA), C16:0 CE, C20:4 CE, C18.0 CE and ribothymidine. These findings suggest Cholesterol esters and GABA may modify the estimated effect of age on bronchodilator response.

scholarly journals Impact of a Pediatric Clinic-Based Multidisciplinary Asthma Education and Management Program

2005 ◽  
Vol 10 (4) ◽  
pp. 254-258 ◽  
Author(s):  
Michelle Condren ◽  
James A Boger
Keyword(s):  
Emergency Department ◽  
Systemic Corticosteroid ◽  
Persistent Asthma ◽  
Clinic Visit ◽  
Management Program ◽  
Emergency Department Visits ◽  
Asthma Education ◽  
Pediatric Clinic ◽  
Children With Asthma ◽  
One Year

OBJECTIVE The objective of this study was to determine if a multidisciplinary asthma education and management program within a general pediatric clinic impacts clinical outcomes of children with asthma. METHODS An asthma education and management clinic was started by a general pediatrician, a pharmacist, and a nurse. At a patient's initial clinic visit, data were collected summarizing hospitalizations, emergency department visits, and number of systemic corticosteroid courses for the previous year. The same data were collected at each subsequent visit. A retrospective review of this data was performed for patients who enrolled in the clinic between February 1999 and 2002 to compare outcomes between the year before enrollment in the clinic and the following year. Patients were included if they received follow-up for at least one year. RESULTS Fifty-seven patients with a mean age of 8.5 years qualified for data analysis. Forty-eight percent of the study population was classified as having moderate persistent asthma, and 11% of patients were severe persistent. Compared to the year prior to clinic enrollment, the number of hospitalizations per patient decreased by 82% (P &lt; .001). Emergency department visits decreased by 81% (P &lt; .001). The number of systemic corticosteroid courses decreased by 72% (P &lt; 0.001). CONCLUSIONS Patient enrollment in a general pediatric clinic-based multidisciplinary asthma education and management program decreases hospitalizations, emergency department visits, and systemic corticosteroid exposure.

scholarly journals Impact of a Diagnostic Therapeutic Educational Pathway (DTEP) Self-Management Program for Asthma Management in Preschool Children

2020 ◽  
Author(s):  
Sebastiano Guarnaccia ◽  
Cristina Quecchia ◽  
Andrea Festa ◽  
Michele Magoni ◽  
Giuseppe Zenoni ◽  
...  
Keyword(s):  
Preschool Children ◽  
Asthma Management ◽  
Population Based ◽  
Incidence Rates ◽  
Management Program ◽  
Emergency Department Visits ◽  
Outpatient Services ◽  
Older Children ◽  
Children With Asthma ◽  
The Impact

Abstract BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years so far. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that, an integrated DTEP program for preschool children not only can provide a real-world assessment for improved wheezing control, but also a measure for reduction of adverse therapeutic related outcomes.

Partners in School Asthma Management: Evaluation of a Self-Management Program for Children With Asthma

2006 ◽  
Vol 76 (6) ◽  
pp. 283-290 ◽  
Author(s):  
L. Kay Bartholomew ◽  
Marianna M. Sockrider ◽  
Stuart L. Abramson ◽  
Paul R. Swank ◽  
Danita I. Czyzewski ◽  
...  
Keyword(s):  
Asthma Management ◽  
Management Program ◽  
Self Management ◽  
Management Evaluation ◽  
Children With Asthma

scholarly journals A Comprehensive Pediatric Asthma Management Program Reduces Emergency Department Visits and Hospitalizations

2016 ◽  
Vol 29 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Khalid H. Safi ◽  
Karla J. Stoermer-Grossman ◽  
Kelley M. Kidwell ◽  
Julie M. Sturza ◽  
Ixsy A. Ramirez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Asthma Management ◽  
Pediatric Asthma ◽  
Management Program ◽  
Emergency Department Visits

scholarly journals Impact of a Diagnostic Therapeutic Educational Pathway (DTEP) Self-Management Program for Asthma Management in Preschool Children

2020 ◽  
Author(s):  
Sebastiano Guarnaccia ◽  
Cristina Quecchia ◽  
Andrea Festa ◽  
Michele Magoni ◽  
Giuseppe Zenoni ◽  
...  
Keyword(s):  
Preschool Children ◽  
Asthma Management ◽  
Population Based ◽  
Incidence Rates ◽  
Management Program ◽  
Emergency Department Visits ◽  
Outpatient Services ◽  
Older Children ◽  
Children With Asthma ◽  
The Impact

Abstract BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have yet been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that a real-world assessment of the integrated DTEP program for preschool children provides evidence for improved wheezing control and reduction of adverse therapeutic related outcomes.

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