You are here

Article Text

Article menu
Download PDFPDF
Acute paediatrics
Implementation of evidence based guidelines for paediatric asthma management in a teaching hospital
  1. J Massie1,
  2. D Efron2,
  3. B Cerritelli1,
  4. M South2,
  5. C Powell3,
  6. M M Haby4,
  7. E Gilbert1,
  8. S Vidmar5,
  9. J Carlin5,
  10. C F Robertson1,
  11. on behalf of the ICAAM Study Group
  1. 1Department of Respiratory Medicine, Murdoch Children’s Research Institute, Royal Children’s Hospital
  2. 2Department of General Medicine, Royal Children’s Hospital
  3. 3Departments of Emergency Medicine & General Medicine, Murdoch Children’s Research Institute, University of Melbourne, Royal Children’s Hospital
  4. 4Centre for Community Child Health, Royal Children’s Hospital
  5. 5Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital
  1. Correspondence to:
    Dr J Massie
    Department of Respiratory Medicine, Royal Children’s Hospital, Flemington Road, Parkville, Victoria 3052, Australia; john.massierch.org.au

Abstract

Aims: To evaluate a systematic approach to the development and implementation of evidence based asthma management guidelines.

Methods: Comparative study of children (2–18 years) with acute asthma; a control cohort (cohort 1) was recruited before implementation of the guidelines and two cohorts were recruited after implementation (cohorts 2 and 3).

Results: There was no difference in the proportion of patients who reattended in the six months following initial presentation for cohort 1 (21.5%), cohort 2 (27.8%), or cohort 3 (25.4%) and no difference in readmission rates (11.4%, 11.3%, 11.0% respectively). There was no difference in measures of asthma morbidity between the cohorts at 3 and 6 months across three domains: interval symptoms, exercise limitation, and bronchodilator use. Of those who did not have a management plan before presentation, one was provided to 46.9% of cohort 1, 74.8% of cohort 2, and 81.1% of cohort 3. There was no difference comparing cohort 2 or cohort 3 with cohort 1 regarding quality of life for either the subjects or their parents.

Conclusions: Implementation of our evidence based guidelines was associated with the improved provision of asthma management plans, but there was no effect on reattendance or readmission to hospital, asthma morbidity, or quality of life. Future efforts to improve asthma management should target specific components of asthma care.

  • ICAAM, improving child and adolescent asthma management
  • RCH, Royal Children’s Hospital

https://doi.org/10.1136/adc.2003.032110

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • This study was funded by grants from the National Health and Medical Research Council of Australia (NH&MRC grant No 98/31401) and the Department of Human Services, Victoria

    • Improving Children and Adolescent Asthma Management (ICAAM) Study Group: Ms Belinda Cerritelli, Dr Daryl Efron, Dr Michelle Haby, Dr Claire Harris, Ms Emma Gilbert, Gill Kainey, Professor Andrew Kemp, Dr John Massie, Professor Frank Oberklaid, Dr Colin Powell, Associate Professor Colin Robertson, Associate Professor Susan Sawyer, Associate Professor Mike South, Dr Mimi Tang

    Linked Articles

    • Atoms
      Atoms
      Howard Bauchner
      Archives of Disease in Childhood 2004; 89 593-593 Published Online First: 21 Jun 2004.