Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach

Valentina Fainardi, Carlo Caffarelli, Barbara Maria Bergamini, Loretta Biserna, Paolo Bottau, Elena Corinaldesi, Arianna Dondi, Martina Fornaro, Battista Guidi, Francesca Lombardi, Maria Sole Magistrali, Elisabetta Marastoni, Alessandra Piccorossi, Maurizio Poloni, Sylvie Tagliati, Francesca Vaienti, Cristina Venturelli, Giampaolo Ricci, Susanna Esposito and on behalf of the Emilia-Romagna Asthma (ERA) Study Group
Additional contact information
Valentina Fainardi: Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
Carlo Caffarelli: Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
Barbara Maria Bergamini: Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
Loretta Biserna: Paediatrics and Neonatology Unit, Ravenna Hospital, AUSL Romagna, 48121 Ravenna, Italy
Paolo Bottau: Paediatrics Unit, Imola Hospital, 40026 Imola, Italy
Elena Corinaldesi: Paediatric Unit, Carpi Hospital, 41012 Carpi, Italy
Arianna Dondi: Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
Martina Fornaro: Paediatrics and Neonatology Unit, Macerata Hospital, ASUR Marche–AV3, 62100 Macerata, Italy
Battista Guidi: Hospital and Territorial Paediatrics Unit, Pavullo Hospital, 41026 Pavullo nel Frignano, Italy
Francesca Lombardi: Paediatrics Unit, Maggiore Hospital, 40133 Bologna, Italy
Maria Sole Magistrali: Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
Elisabetta Marastoni: Paediatrics Unit, Santa Maria Nuova Hospital, AUSL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy
Alessandra Piccorossi: Paediatrics and Paediatric Intensive Care Unit, Cesena Hospital, AUSL Romagna, 47521 Cesena, Italy
Maurizio Poloni: Paediatrics Unit, Rimini Hospital, AUSL Romagna, 47921 Rimini, Italy
Sylvie Tagliati: Paediatric Clinic, Ferrara Hospital, 44124 Ferrara, Italy
Francesca Vaienti: Paediatrics Unit, G.B. Morgagni—L. Pierantoni Hospital, AUSL Romagna, 47121 Forlì, Italy
Cristina Venturelli: Paediatrics Unit, Sassuolo Hospital, 41049 Sassuolo, Italy
Giampaolo Ricci: Alma Mater Studiorum, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Susanna Esposito: Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
on behalf of the Emilia-Romagna Asthma (ERA) Study Group: Membership of the ERA Study Group is provided in the Acknowledgments.

IJERPH, 2021, vol. 18, issue 23, 1-19

Abstract: Bronchial asthma is the most frequent chronic disease in children and affects up to 20% of the pediatric population, depending on the geographical area. Asthma symptoms vary over time and in intensity, and acute asthma attack can resolve spontaneously or in response to therapy. The aim of this project was to define the care pathway for pediatric patients who come to the primary care pediatrician or Emergency Room with acute asthmatic access. The project was developed in the awareness that for the management of these patients, broad coordination of interventions in the pre-hospital phase and the promotion of timely and appropriate assistance modalities with the involvement of all health professionals involved are important. Through the application of the RAND method, which obliges to discuss the statements derived from the guidelines, there was a clear increase in the concordance in the behavior on the management of acute asthma between primary care pediatricians and hospital pediatricians. The RAND method was found to be useful for the selection of good practices forming the basis of an evidence-based approach, and the results obtained form the basis for further interventions that allow optimizing the care of the child with acute asthma attack at the family and pediatric level. An important point of union between the primary care pediatrician and the specialist hospital pediatrician was the need to share spirometric data, also including the use of new technologies such as teleconsultation. Monitoring the progress of asthma through spirometry could allow the pediatrician in the area to intervene early by modifying the maintenance therapy and help the patient to achieve good control of the disease.

Keywords: asthma; good clinical practices; respiratory exacerbation; spirometry; teleconsultation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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