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Management of severe asthma in pediatric patients by an interdisciplinary team

Teijeiro A*, Vieyra RE, Arteaga AE, Ermoli M, Saenz G, Bustos C, Raiden MG, Yanez A

Introduction: The implementation of interdisciplinary care strategies for the follow-up of patients with asthma has proven to be very effective in improving evolution of these children.

Objectives: To identify, through an interdisciplinary team, the differences in characteristics and management between patients with Severe Difficult to Treat Asthma (SDCA) and Severe Treatment Resistant Asthma (STRA). A secondary objective was reducing rates of hospitalizations and visits to the emergency ward, as well as exacerbations.

Methods: Analysis of case series of patients with UCSA diagnosis admitted to the pneumonology service of the pediatric hospital of Córdoba, aged between 5 and 15 year-old, with a 6 months followup.

Results: 23 patients entered the study, 47.82% were defined as SDCA and 52.17% STRA. During the first 6 months of the program, hospitalization rate was only 4% (p=0.001). Number of visits to the emergency room decreased to 39.13% (p=0.003). Regarding the inhalation technique, 73.9% (n=17) presented improvement (p=0.0001). Only 13% (n=3) of the patients continued with ACT score <20 (p=0.0001). We found differences in the use of rescue medication (p=0.003) and greater attendance at emergency rooms (p=0.005) during the 6 months evaluation process in the treatmentresistant asthmatic patients group.

Conclusion: Implementing this type of interdisciplinary program was associated with a marked improvement in all modifiable variables of asthma in patients with SDCA, leading to a better management of UCSA patients.