Application and implementation of the GINA asthma guidelines by specialist and primary care physicians: a longitudinal follow-up study on 264 children
Sebastiano Guarnaccia, Andrea Lombardi, Alessandro Gaffurini, Mariateresa Chiarini, Serena Domenighini, Emanuele D'Agata, Richard Fabian Schumacher, Raffaele Spiazzi, Luigi D Notarangelo, Sebastiano Guarnaccia, Andrea Lombardi, Alessandro Gaffurini, Mariateresa Chiarini, Serena Domenighini, Emanuele D'Agata, Richard Fabian Schumacher, Raffaele Spiazzi, Luigi D Notarangelo
Abstract
Aims: To implement GINA guidelines and to assess their impact on the management of childhood asthma.
Methods: A working group of primary care physicians (PCPs) and specialists developed a GINA-based clinical pathway. We then monitored the impact on 385 children (aged 0-15 years) referred to the respiratory outpatients clinic at the University Children's Hospital, Brescia, Italy by 179 PCPs between September 2003 and July 2005.
Results: Mean follow-up for 264 children with complete datasets was 10 months. Guidelines were followed by 94.6% of the PCPs. 98.6% of children learned to manage exacerbations. Half of the patients with persistent symptoms became intermittently symptomatic. Maintenance treatment was suspended in 47.2%, reduced in 27.6%, and increased in 4.9%. Asthma severity diminished (p<0.0001) and requirement for medication for exacerbations was significantly reduced (p<0.0001).
Conclusions: Regular specialist visits, a website, and a written management plan shared by all those involved, led to clinical improvements as well as a reduction in, and more efficient use of, asthma medication.
Conflict of interest statement
None declared.
Source: PubMed