RT Journal Article
SR Electronic
T1 Outpatient management of childhood asthma by paediatrician or asthma nurse: randomised controlled study with one year follow up
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 968
OP 973
DO 10.1136/thorax.58.11.968
VO 58
IS 11
A1 A W A Kamps
A1 P L P Brand
A1 J L L Kimpen
A1 A R Maillé
A1 A W Overgoor-van de Groes
A1 L C J A M van Helsdingen-Peek
A1 R J Roorda
YR 2003
UL http://thorax.bmj.com/content/58/11/968.abstract
AB Background: Until now, care provided by asthma nurses has been additional to care provided by paediatricians. A study was undertaken to compare nurse led outpatient management of childhood asthma with follow up by a paediatrician. Methods: Seventy four children referred because of insufficient control of persistent asthma were randomly allocated to 1 year follow up by a paediatrician or asthma nurse. The main outcome measure was the percentage of symptom-free days. Additional outcome measures were airway hyperresponsiveness, lung function, daily dose of inhaled corticosteroids (ICS), number of exacerbations, number of additional visits to the general practitioner, absence from school, functional health status, and disease specific quality of life. Results: There were no significant differences at the end of the 1 year study period between the two treatment groups in percentage of symptom-free days (mean difference 2.5%; 95% CI −8.8 to 13.8), airway hyperresponsiveness (log10 PD20 0.06; −0.19 to 0.32), functional health status (10.1; −0.3 to 19.8), disease specific quality of life of patients (0.08; −0.9 to 0.7), and disease specific quality of life of caregivers (0.09; −0.2 to 0.3), nor in any other outcome parameters. Most outcome parameters improved considerably over the 1 year study period. These improvements were achieved although the daily dose of ICS was reduced by a mean of 26% compared with the dose received by children at referral. All parents were satisfied with the asthma care received. Conclusions: After initial assessment in a multidisciplinary clinic, childhood asthma can be successfully managed by an asthma nurse in close cooperation with a paediatrician. During close follow up by paediatrician or asthma nurse, asthma control improved despite a reduction in ICS dose.