Medico e Bambino
2012
Novembre 2012
numero 9
PAGINE ELETTRONICHE




Valutazione dell’efficacia di un percorso terapeutico-educazionale nel migliorare il controllo dell’asma in bambini e adolescenti

Sebastiano Guarnaccia1, Marina Bianchi2, Emanuele D’Agata1, Giusi Boldini1, Ada Pluda1, Adriana Boldi1, Antonio Clavenna2, Massimo Cartabia2, Maurizio Bonati2
1Laboratorio Clinico Pedagogico e Ricerca Biomedica, Ospedale dei Bambini, Brescia
2Laboratorio di Salute Materno-Infantile, Dipartimento di Salute Pubblica, Istituto di Ricerche Farmacologiche “Mario Negri”, Milano

indirizzo per corrispondenza:marina.bianchi@marionegri.it

Evaluation of efficacy of a therapeutic-educational programme addressed to improve asthma control, in asthmatic children and adolescents
Key words
Childhood asthma, Anti-asthmatic drugs, Asthma control, Therapeutic education, Asthma management

Summary
Aim - To evaluate whether the therapeutic-educational programme “Io e l’Asma”, addressed to asthmatic children/adolescents and their families would improve asthma control and implement asthma guidelines in an Italian setting in which the prevalence of asthma in 6-15 year-old children is 4.2%, and only 9% undergo a specialist visit.
Methods - Observational retrospective pre-post intervention study. The programme “Io e l’Asma” included three visits and two educational courses (one individually-based and one for groups). Outcome measures were the degree of asthma control (not controlled, partially controlled and controlled) and the percentage of children who benefit from the intervention, defined as the improvement of the degree of control. Moreover, hospitalizations for asthma and school-missing days because of asthma were calculated.
Results - Between September 2007 and July 2010, 262 asthmatic children and adolescents aged between 6-15 underwent and completed the programme “Io e l’Asma”. The proportion of children with an asthma rated as “controlled” increased from 44 to 79% (χ2 M-H = 66.8; p<0.0001). In all, 42% improved their asthma control and 38% maintained a good control as before the intervention. At the end 49% of cases did not need any controller therapy and 49% received fluticasone only, compared to 72 and 16%, respectively, at the beginning of the programme. 10% underwent hospitalization: 7% before, 2% during, and 1% after intervention (χ2 M-H =15.4; p=0.0001). 20% missed school: 14% before, 4% during, and 2% after intervention (χ2 M-H = 24.4; p=0.0001).
Conclusions - The therapeutic-educational programme and the follow-up by the doctor led to clinical improvements as well as a reduction in, or more efficient use of, asthma medication. The efficacy of this programme suggests the inappropriateness of the therapeutic-educational level in asthma management.


Vuoi citare questo contributo?
S. Guarnaccia, M. Bianchi, E. D’Agata, G. Boldini, A. Pluda, A. Boldi, A. Clavenna, M. Cartabia, M. Bonati . VALUTAZIONE DELL’EFFICACIA DI UN PERCORSO TERAPEUTICO-EDUCAZIONALE NEL MIGLIORARE IL CONTROLLO DELL’ASMA IN BAMBINI E ADOLESCENTI . Medico e Bambino 2012;31:600-602 https://www.medicoebambino.com/?id=1209_600.pdf

Una neonata con ipotonia e un viso particolare

Augusto Biasini1, Luca Rocchetti2, Lucia Marvulli1, Maria Rosa Pizzitola3
1UO terapia Intensiva Pediatrica e Neonatale Osp. M.bufalini Cesena
2UO Genetica Medica Area Vasta Romagna
3Pediatra di Famiglia

indirizzo per corrispondenza:abiasini@ausl-cesena.emr.it

An hypotonic newborn with a special look
Key words
Congenital hypotonia, Joint-meeting, Communication

Summary
The cure and care of the children with congenital chronic disabilities is the real challenge for the hospital-territorial network cooperative model. This organizational strategy will achieve success only if all the caregivers work strictly together to obtain the best assistance of the children and their families. A case report of a newborn with global muscles weakness and a particular face, is described outlining this way of caring. The reader is driven to the correct diagnosis by following a logical approach. Adequate communication of the disease is of crucial importance and was made during the joint-meeting between the healthcare team and the family. This is the appropriate method to maintain a good relationship, giving parents hope despite the awareness of the uncertainty of outcomes.


Vuoi citare questo contributo?
A. Biasini, L. Rocchetti, L. Marvulli, M.R. Pizzitola. UNA NEONATA CON IPOTONIA E UN VISO PARTICOLARE. Medico e Bambino 2012;31:600-602 https://www.medicoebambino.com/?id=1209_600.pdf






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