Introduction of a new paediatric asthma guideline: Effects on asthma control levels

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Worldwide, asthma is considered the most common chronic disease among children 1. The major aim of asthma treatment is to achieve and maintain asthma control. Since the revision in 2006, the Global Initiative for Asthma (GINA) guideline focuses on asthma control rather than on asthma severity. Most patients can achieve control with a stepwise approach of the treatment 1. However, numerous surveys report suboptimal asthma control 5, which is associated with lower quality of life, more emergency care visits, increased healthcare costs and airway inflammation causing remodelling 14.
In 2004, we assessed the level of asthma control in a Dutch paediatric outpatient population 15. In our study, only one in ten patients was optimally controlled, which was comparable with other surveys. A limited number of children received step‐up of their asthma treatment in case of uncontrolled asthma and step‐down therapy in case of controlled disease.
In 2008, a national paediatric asthma management guideline, based on the international GINA guideline, was launched in the Netherlands 16.
So far, no studies investigated the influence of this Dutch guideline on the level of asthma control in children. We hypothesized that an increase in asthma control has occurred due to the introduction of the guideline focusing on asthma control. We aim to assess (i) the level of asthma control in a paediatric outpatient clinic; (ii) the level of agreement of asthma control values as evaluated by patients, paediatricians and the objective GINA criteria (gold standard); (iii) the frequency of step‐up and step‐down treatment regimens by the paediatrician.

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