BACKGROUND: The effectiveness of pediatric asthma management programs in reducing health services utilization during exacerbations in developing countries is not widely studied. This study was carried out to assess the effectiveness of an asthma management program to reduce the overall health services utilization by acute asthma in children and adolescents. METHODS: In this historical population-based real-life cohort study, we selected 582 patients with asthma aged 4-15 living in deprived areas in the town of Itabira, Brazil, of which 470 cases were assisted by the asthma management program and 112 were controls. The end point was the first physician-diagnosed asthma exacerbation occurring after study enrollment and within 12 months after admission. All 470 cases received a written plan about exacerbation self-management, including the use of inhaled albuterol at home. Three hundred and seventeen out of 470 cases (67.4%) were also treated with beclomethasone diproprionate (BDP). RESULTS: Both groups were comparable regarding gender, age group, and place of residence. At the end of the study, only 5% of cases vs 34% of controls did seek health services because of acute asthma (P < 0.01). Statistical difference also remained when comparing the 112 controls with the 153 cases not treated with com BDP (Hazard Ratio = 0.04, 95% CI, 0.01-0.14, P < 0.01). CONCLUSIONS: Results have demonstrated the effectiveness of the pediatric asthma management program in reducing dependence on the health services for acute asthma. Effectiveness was also observed in subjects with no use of BDP.
BACKGROUND: The effectiveness of pediatric asthma management programs in reducing health services utilization during exacerbations in developing countries is not widely studied. This study was carried out to assess the effectiveness of an asthma management program to reduce the overall health services utilization by acute asthma in children and adolescents. METHODS: In this historical population-based real-life cohort study, we selected 582 patients with asthma aged 4-15 living in deprived areas in the town of Itabira, Brazil, of which 470 cases were assisted by the asthma management program and 112 were controls. The end point was the first physician-diagnosed asthma exacerbation occurring after study enrollment and within 12 months after admission. All 470 cases received a written plan about exacerbation self-management, including the use of inhaled albuterol at home. Three hundred and seventeen out of 470 cases (67.4%) were also treated with beclomethasone diproprionate (BDP). RESULTS: Both groups were comparable regarding gender, age group, and place of residence. At the end of the study, only 5% of cases vs 34% of controls did seek health services because of acute asthma (P < 0.01). Statistical difference also remained when comparing the 112 controls with the 153 cases not treated with com BDP (Hazard Ratio = 0.04, 95% CI, 0.01-0.14, P < 0.01). CONCLUSIONS: Results have demonstrated the effectiveness of the pediatric asthma management program in reducing dependence on the health services for acute asthma. Effectiveness was also observed in subjects with no use of BDP.
Authors: N G Papadopoulos; H Arakawa; K-H Carlsen; A Custovic; J Gern; R Lemanske; P Le Souef; M Mäkelä; G Roberts; G Wong; H Zar; C A Akdis; L B Bacharier; E Baraldi; H P van Bever; J de Blic; A Boner; W Burks; T B Casale; J A Castro-Rodriguez; Y Z Chen; Y M El-Gamal; M L Everard; T Frischer; M Geller; J Gereda; D Y Goh; T W Guilbert; G Hedlin; P W Heymann; S J Hong; E M Hossny; J L Huang; D J Jackson; J C de Jongste; O Kalayci; N Aït-Khaled; S Kling; P Kuna; S Lau; D K Ledford; S I Lee; A H Liu; R F Lockey; K Lødrup-Carlsen; J Lötvall; A Morikawa; A Nieto; H Paramesh; R Pawankar; P Pohunek; J Pongracic; D Price; C Robertson; N Rosario; L J Rossenwasser; P D Sly; R Stein; S Stick; S Szefler; L M Taussig; E Valovirta; P Vichyanond; D Wallace; E Weinberg; G Wennergren; J Wildhaber; R S Zeiger Journal: Allergy Date: 2012-06-15 Impact factor: 13.146
Authors: Elham Hossny; Nelson Rosario; Bee Wah Lee; Meenu Singh; Dalia El-Ghoneimy; Jian Yi Soh; Peter Le Souef Journal: World Allergy Organ J Date: 2016-08-12 Impact factor: 4.084
Authors: Rafael Stelmach; Alcindo Cerci Neto; Ana Cristina de Carvalho Fernandez Fonseca; Eduardo Vieira Ponte; Gerardo Alves; Ildely Niedia Araujo-Costa; Laura Maria de Lima Belizário Facury Lasmar; Luci Keiko Kuromoto de Castro; Maria Lucia Medeiros Lenz; Paulo Silva; Alberto Cukier; Alexssandra Maia Alves; Aline Silva Lima-Matos; Amanda da Rocha Oliveira Cardoso; Ana Luisa Godoy Fernandes; Bruno Piassi de São-José; Carlos Antônio Riedi; Deborah Schor; Décio Medeiros Peixoto; Diego Djones Brandenburg; Elineide Gomes Dos Santos Camillo; Faradiba Sarquis Serpa; Heli Vieira Brandão; João Antonio Bonfadini Lima; Jorge Eduardo Pio; Jussara Fiterman; Maria de Fátima Anderson; Maria do Socorro de Lucena Cardoso; Marcelo Tadday Rodrigues; Marilyn Nilda Esther Urrutia Pereira; Marti Antila; Sonia Maria Martins; Vanessa Gonzaga Tavares Guimarães; Yara Arruda Marques Mello; Wenderson Clay Correia de Andrade; William Salibe-Filho; Zelina Maria da Rocha Caldeira; Álvaro Augusto Souza da Cruz-Filho; Paulo Camargos Journal: J Bras Pneumol Date: 2015 Jan-Feb Impact factor: 2.624