Novembre 2012 - Volume XXXI - numero 9
Pagine elettroniche
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
Key words: Childhood asthma, Anti-asthmatic drugs, Asthma control, Therapeutic education, Asthma management
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.
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