Centro "Io e l'Asma", Ospedale dei Bambini, ASST Spedali Civili, Brescia, Italy.
Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Pediatr Allergy Immunol. 2018 Mar;29(2):180-185. doi: 10.1111/pai.12839. Epub 2017 Dec 19.
In spite of some evidence for positive effects of patient's education to asthma self-management by randomized clinical trials, there are few studies on the impact of patient' s educational programs in the real world. We aimed to assess the impact of a diagnostic therapeutic educational pathway (DTEP) on asthma control of children and adolescents by comparing frequency of outcomes indicative of asthma control before and after attending the pathway.
This is a retrospective cohort study including all patients aged 6-11 and 12-17 years who attended the DTEP in 2007-2014. The DTEP includes 3 specialist's evaluations at 8- to 12-week intervals and two follow-up visits. Patients and their parents receive an educational course concerning prevention measures, early recognition of symptoms, and appropriate use of drugs and devices. The rates of hospitalizations, outpatient services, emergency room visits, and drug prescriptions were considered as outcomes and computed as number of events divided by person-time.
A total of 806 patients were enrolled. A statistically significant decrease in rates from before to after DTEP was observed for almost all outcomes, in both age groups, with relative risks ranging from 0.12 to 0.60. The rates of drug prescription showed a statistically significant decrease, from before to after DTEP, for each type of medicine for asthma, in both age groups, from percent difference of -66% to -24.3%.
The positive impact of this program on the outcomes indicative of asthma control in both children and adolescents suggests that it may be valuable for asthma management.
尽管随机临床试验有一些证据表明患者教育对哮喘自我管理有积极影响，但在现实世界中，关于患者教育计划对哮喘的影响的研究很少。我们旨在通过比较参加途径前后表明哮喘控制的结果的频率，评估诊断治疗教育途径（DTEP）对儿童和青少年哮喘控制的影响。
这是一项回顾性队列研究，包括 2007-2014 年期间参加 DTEP 的所有 6-11 岁和 12-17 岁的患者。DTEP 包括 3 次专家评估，间隔 8-12 周，以及 2 次随访。患者及其父母接受有关预防措施、症状早期识别以及适当使用药物和设备的教育课程。住院、门诊服务、急诊室就诊和药物处方的比率被视为结果，并以事件数除以人时计算。
共纳入 806 名患者。几乎所有结果都观察到 DTEP 前后的发生率呈统计学显著下降，在两个年龄组中，相对风险范围从 0.12 到 0.60。在两个年龄组中，每种哮喘药物的药物处方率都显示出从 DTEP 前到后的统计学显著下降，从百分比差异-66%到-24.3%。
该方案对儿童和青少年哮喘控制结果的积极影响表明，它可能对哮喘管理具有价值。
