A pediatric asthma management program in a low-income setting resulting in reduced use of health service for acute asthma

  1. W. C. C. Andrade1,
  2. P. Camargos2,
  3. L. Lasmar2,
  4. J. Bousquet3

Article first published online: 14 JUN 2010

DOI: 10.1111/j.1398-9995.2010.02405.x

Issue

Allergy

Allergy

Volume 65, Issue 11, pages 1472–1477, November 2010

Additional Information

How to Cite

Andrade, W. C. C., Camargos, P., Lasmar, L. and Bousquet, J. (2010), A pediatric asthma management program in a low-income setting resulting in reduced use of health service for acute asthma. Allergy, 65: 1472–1477. doi: 10.1111/j.1398-9995.2010.02405.x

Author Information

  1. 1

    Municipal Health Authority, Pediatric Asthma Management Program Chairman, Itabira, Brazil

  2. 2

    Pediatric Pulmonology Unit, University Hospital and Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil

  3. 3

    Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, Montpellier, France

*Prof. Paulo Camargos, Department of Pediatrics, Medical School, Federal University of Minas Gerais, Avenida Alfredo Balena, 190/Room 267, 30130-100 Belo Horizonte, Brazil. Tel.: +55 31 3409 9772 Fax: + 55 31 3409 9664 E-mail: pcamargs@medicina.ufmg.br or pauloamcamargos@gmail.com

Publication History

  1. Issue published online: 14 JUN 2010
  2. Article first published online: 14 JUN 2010
  3. Accepted for publication 12 April 2010

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Keywords:

  • acute asthma;
  • adolescents;
  • children;
  • education;
  • health services;
  • management program

To cite this article: Andrade WCC, Camargos P, Lasmar L, Bousquet J. A pediatric asthma management program in a low-income setting resulting in reduced use of health service for acute asthma. Allergy 2010; 65: 1472–1477.

Abstract

Background:  The effectiveness of pediatric asthma management programs in reducing health services utilization during exacerbations in developing countries is not widely studied. This study was carried out to assess the effectiveness of an asthma management program to reduce the overall health services utilization by acute asthma in children and adolescents.

Methods:  In this historical population-based real-life cohort study, we selected 582 patients with asthma aged 4–15 living in deprived areas in the town of Itabira, Brazil, of which 470 cases were assisted by the asthma management program and 112 were controls. The end point was the first physician-diagnosed asthma exacerbation occurring after study enrollment and within 12 months after admission. All 470 cases received a written plan about exacerbation self-management, including the use of inhaled albuterol at home. Three hundred and seventeen out of 470 cases (67.4%) were also treated with beclomethasone diproprionate (BDP).

Results:  Both groups were comparable regarding gender, age group, and place of residence. At the end of the study, only 5% of cases vs 34% of controls did seek health services because of acute asthma (P < 0.01). Statistical difference also remained when comparing the 112 controls with the 153 cases not treated with com BDP (Hazard Ratio = 0.04, 95% CI, 0.01–0.14, P < 0.01).

Conclusions:  Results have demonstrated the effectiveness of the pediatric asthma management program in reducing dependence on the health services for acute asthma. Effectiveness was also observed in subjects with no use of BDP.

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