Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Ardura-Garcia, C; Pedersen, ESL; Mallet, MC; de, Jong, CCM; Barben, J; Jochmann, A; Jung, A; Mueller-Suter, D; Regamey, N; Singer, F; Kuehni, CE; SPAC Study Team.
Treatment Decisions in Children With Asthma in a Real-Life Clinical Setting: The Swiss Paediatric Airway Cohort.
J Allergy Clin Immunol Pract. 2022; 10(4):1038-1046.e8
Doi: 10.1016/j.jaip.2021.10.026
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Singer Florian
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- Abstract:
- BACKGROUND: Asthma treatment should be modified according to symptom control and future risk, but there are scarce data on what drives treatment adjustments in routine tertiary care. OBJECTIVE: We studied factors that drive asthma treatment adjustment in pediatric outpatient clinics. METHODS: We performed a cross-sectional analysis of the Swiss Paediatric Airway Cohort, a clinical cohort of 0- to 16-year-old children seen by pediatric pulmonologists. We collected information on diagnosis, treatment, lung function, and FeNO from hospital records; and on symptoms, sociodemographic, and environmental factors from a parental questionnaire. We used reported symptoms to classify asthma control and categorized treatment according to the 2020 Global Initiative for Asthma guidelines. We used multivariable logistic regression to study factors associated with treatment adjustment (step-up or down vs no change). RESULTS: We included 551 children diagnosed with asthma (mean age, 10 years; 37% female). At the clinical visit, most children were prescribed Global Initiative for Asthma step 3 (35%). Compared with previsit treatment, 252 children remained on the same step (47%), 227 were stepped up (42%), and 58 were stepped down (11%). Female sex (adjusted odds ratio [aOR] = 1.61; 95% confidence interval [CI], 1.05-2.47), poor asthma control (aOR = 3.08; 95% CI, 1.72-5.54), and lower FEV1 Z-score (aOR = 0.70; 95% CI, 0.56-0.86 per one Z-score increase) were independently associated with treatment step-up, and low FeNO (aOR = 2.34; 95% CI, 1.23-4.45) was associated with treatment step-down, with marked heterogeneity between clinics. CONCLUSIONS: In this tertiary care real-life study, we identified main drivers for asthma treatment adjustment. These findings may help improve both asthma management guidelines and clinical practice.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent - administration & dosage
- Asthma - drug therapy, epidemiology
- Child - administration & dosage
- Child, Preschool - administration & dosage
- Cohort Studies - administration & dosage
- Cross-Sectional Studies - administration & dosage
- Female - administration & dosage
- Humans - administration & dosage
- Infant - administration & dosage
- Infant, Newborn - administration & dosage
- Male - administration & dosage
- Surveys and Questionnaires - administration & dosage
- Switzerland - epidemiology
- Find related publications in this database (Keywords)
- Asthma management
- Children
- Clinical practice