Pediatric pulmonology · 2025
Impact of a Multidisciplinary Program in the Categorization and Management of Children With Severe Asthma.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Teijeiro Alvaro, Gómez Silvia, Grenat Andrés, Bustos Carolina, Morales Benigno, Prunier Mariana, Hernandez Ludmila, Bush Andrew
Аннотация
BACKGROUND: Asthma is an important global healthcare problem, and severe asthma affects 5%-7% of children with asthma. This small percentage results in a heavy burden of disease.
OBJECTIVES: To describe the characteristics of severe asthma patients in Argentina and their evolution over time, and to evaluate the effectiveness of a multidisciplinary team (MDT) approach in the clinical management of these children.
METHODS: Prospective, observational, longitudinal study in an Argentinian Pulmonology Service.
RESULTS: Fifty-three children aged 5-15 years old diagnosed with severe asthma were studied over a period of 6 months; 40/53 (76%) patients were unable to access therapy (WHO Group 1) and 27/40 were finally categorized as patients with difficult-to-treat asthma after completing the program. The remaining 13 patients in Group 1 who were non-responders were classified as severe therapy-resistant asthma (STRA). Of the 13 patients who were not initially in Group 1, 8/13 were responders who no longer had severe asthma and were thus classified as difficult-to-treat asthma and the remaining five had STRA; thus 35/53 (66%) of the treated patients were no longer classified as severe asthma after completing the program. We identified adverse psychosocial factors identified in 47%. 77% had allergic rhinitis. Most had normal spirometry. Blood eosinophil count was median of 320 cell/µL, and median total IgE was 313 UI/ml. During the program, asthma symptoms, quality of life and asthma exacerbations all improved significantly.
CONCLUSION: Our multidisciplinary approach was associated with better outcomes in most patients with severe asthma. This model could profitably be adopted in other low-resource settings.
OBJECTIVES: To describe the characteristics of severe asthma patients in Argentina and their evolution over time, and to evaluate the effectiveness of a multidisciplinary team (MDT) approach in the clinical management of these children.
METHODS: Prospective, observational, longitudinal study in an Argentinian Pulmonology Service.
RESULTS: Fifty-three children aged 5-15 years old diagnosed with severe asthma were studied over a period of 6 months; 40/53 (76%) patients were unable to access therapy (WHO Group 1) and 27/40 were finally categorized as patients with difficult-to-treat asthma after completing the program. The remaining 13 patients in Group 1 who were non-responders were classified as severe therapy-resistant asthma (STRA). Of the 13 patients who were not initially in Group 1, 8/13 were responders who no longer had severe asthma and were thus classified as difficult-to-treat asthma and the remaining five had STRA; thus 35/53 (66%) of the treated patients were no longer classified as severe asthma after completing the program. We identified adverse psychosocial factors identified in 47%. 77% had allergic rhinitis. Most had normal spirometry. Blood eosinophil count was median of 320 cell/µL, and median total IgE was 313 UI/ml. During the program, asthma symptoms, quality of life and asthma exacerbations all improved significantly.
CONCLUSION: Our multidisciplinary approach was associated with better outcomes in most patients with severe asthma. This model could profitably be adopted in other low-resource settings.