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Fainardi V, Caffarelli C, Bergamini BM, et al. Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach. Int J Environ Res Public Health. 2021;18(23)doi: 10.3390/ijerph182312775.
Fainardi, V., Caffarelli, C., Bergamini, B. M., Biserna, L., Bottau, P., Corinaldesi, E., Dondi, A., Fornaro, M., Guidi, B., Lombardi, F., Magistrali, M. S., Marastoni, E., Piccorossi, A., Poloni, M., Tagliati, S., Vaienti, F., Venturelli, C., Ricci, G., Esposito, S., & On Behalf Of The Emilia-Romagna Asthma Era Study Group. (2021). Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach. International journal of environmental research and public health, 18(23), . https://doi.org/10.3390/ijerph182312775
Fainardi, Valentina, et al. "Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach." International journal of environmental research and public health vol. 18,23 (2021). doi: https://doi.org/10.3390/ijerph182312775
Fainardi V, Caffarelli C, Bergamini BM, Biserna L, Bottau P, Corinaldesi E, Dondi A, Fornaro M, Guidi B, Lombardi F, Magistrali MS, Marastoni E, Piccorossi A, Poloni M, Tagliati S, Vaienti F, Venturelli C, Ricci G, Esposito S, On Behalf Of The Emilia-Romagna Asthma Era Study Group. Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach. Int J Environ Res Public Health. 2021 Dec 03;18(23). doi: 10.3390/ijerph182312775. PMID: 34886505; PMCID: PMC8657661.
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Int J Environ Res Public Health. 2021 Dec 03;18(23). doi: 10.3390/ijerph182312775.

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

International journal of environmental research and public health

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, On Behalf Of The Emilia-Romagna Asthma Era Study Group

Affiliations

  1. Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
  2. Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy.
  3. Paediatrics and Neonatology Unit, Ravenna Hospital, AUSL Romagna, 48121 Ravenna, Italy.
  4. Paediatrics Unit, Imola Hospital, 40026 Imola, Italy.
  5. Paediatric Unit, Carpi Hospital, 41012 Carpi, Italy.
  6. Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
  7. Paediatrics and Neonatology Unit, Macerata Hospital, ASUR Marche-AV3, 62100 Macerata, Italy.
  8. Hospital and Territorial Paediatrics Unit, Pavullo Hospital, 41026 Pavullo nel Frignano, Italy.
  9. Paediatrics Unit, Maggiore Hospital, 40133 Bologna, Italy.
  10. Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy.
  11. Paediatrics Unit, Santa Maria Nuova Hospital, AUSL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy.
  12. Paediatrics and Paediatric Intensive Care Unit, Cesena Hospital, AUSL Romagna, 47521 Cesena, Italy.
  13. Paediatrics Unit, Rimini Hospital, AUSL Romagna, 47921 Rimini, Italy.
  14. Paediatric Clinic, Ferrara Hospital, 44124 Ferrara, Italy.
  15. Paediatrics Unit, G.B. Morgagni-L. Pierantoni Hospital, AUSL Romagna, 47121 Forlì, Italy.
  16. Paediatrics Unit, Sassuolo Hospital, 41049 Sassuolo, Italy.
  17. Alma Mater Studiorum, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.

PMID: 34886505 PMCID: PMC8657661 DOI: 10.3390/ijerph182312775

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

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