Joint consultation for high-risk asthmatic children and their families, with pediatrician and child psychiatrist as co-therapists: model and evaluation.

Although a very common disease, childhood asthma can be a life-threatening condition. Psychosocial determinants have been acknowledged to trigger severe asthma. The authors review current knowledge about how psychosocial factors influence childhood asthma, with a special focus on compliance with treatment and family interaction. The authors describe their experience of joint treatment of high-risk asthmatic children and their families. The pediatrician and child psychiatrist work as co-therapists, and the results of this intervention are investigated. Forty-one high-risk asthmatics and their families were followed in the joint-consultation program. Two years after the onset of joint consultation, a significant improvement was found in symptom score, treatment score, and compliance score. The number of hospital admissions and of days spent in hospital decreased significantly. The cost of care was subsequently cut by two-thirds, despite the added cost of psychiatric care. The authors conclude that it is possible for doctors of the body and of the mind to share consultation work, with a positive impact on both the patient's health and the cost of treatment.