Asthma is a chronic disease that causes the airways to swell and narrow. This causes wheezing, difficulty breathing, chest tightness and cough, with these symptoms varying in severity and frequency from one person to another. WHO estimates that there are currently 235 million patients with asthma, being the most frequent chronic disease in children.
Asthma is present in all countries, regardless of its degree of development and if it is not diagnosed correctly or receives the appropriate treatment, it will create an important burden for patients and their families. Today we talk about a comprehensive guide that addresses childhood asthma in the form of 21 questions and answers: the Clinical Practice Guide on Childhood Asthma.
This guide has been carried out within the collaboration agreement signed by the Carlos III and Osteba Health Institute, within the framework of the activities of the Spanish Network of Technology and Performance Evaluation Agencies of the National Health System. The guide makes recommendations on both diagnostic and asthma management questions that have not been addressed in other previous clinical practice guidelines.
It also addresses issues related to controversial aspects of the disease and includes pediatric issues such as the natural history of the disease, triggers, predictive indices of asthma and educational aspects.
The guide's development group is made up of pediatricians, primary and specialized care nurses, pediatric pulmonologists, as well as a pharmacist and a family doctor and other experts in the research and development of clinical practice guidelines.
It is primarily aimed at primary care and hospital professionals involved in the health care of pediatric patients with asthma and Some of the recommendations are also addressed to professionals in the educational field. Of course, pregnant women and parents interested in expanding information about it will also find interesting content, as indicated in the content summary:
The main objective of this guide is to help health professionals, children with asthma and their parents and / or caregivers to control pediatric patients with asthma in the most appropriate way and provide them with the appropriate tools to address and treat it. pathology.
Contents of the Clinical Practice Guide on Child Asthma
The guide is structured by chapters, in which The 21 questions are answered Initially formulated and appearing at the beginning of it, at the end of each chapter, a summary of the evidence and recommendations are presented. Throughout the text, the quality of the evidence described is indicated. The questions asked are the following:
Primary and secondary prevention
Is the continued use of paracetamol during pregnancy a risk factor for developing asthma at school age?
Is the continued use of paracetamol in infants a risk factor for developing asthma at school age?
In children with asthma and PRICK / RAST positive for cow's milk, can the consumption of cow's milk cause symptoms or increase their severity?
Asthma Prediction in School Age
What is the most appropriate predictive index to predict the evolution to asthma in children under three years with wheezing clinic?
Could the frequency of wheezing episodes serve as a predictive index of persistent asthma at school age?
Does the measurement of FeNO in children under five with wheezing help predict the presence of asthma at school age?
Diagnosis and monitoring of treatment
What is the usefulness of measuring FeNO in children older than five years with doubtful asthma symptoms?
What is the effectiveness of FeNO measurement to guide treatment with inhaled glucocorticoids in children older than five years with asthma?
Pharmacotherapy
In preschool children with wheezing / asthma episodes, is montelukast treatment effective?
In children older than five years with mild persistent asthma, what is the efficacy of preventive treatment with inhaled glucocorticoids versus montelukast?
What is the efficacy of macrolides in the treatment, both in exacerbations and prevention, of preschool children with asthma / wheezing?
What is the effectiveness of the different ICGs for the maintenance treatment of children with asthma?
In preschool children with episodes of recurrent wheezing and without symptoms between crises, is treatment with inhaled glucocorticoids during colds effective in preventing asthma exacerbations?
In children with mild persistent asthma, what is the efficacy of treatment with inhaled glu-cocorticoids used intermittently (during viral infections or seasonally) compared to continuous treatment?
In children with asthma and drug treatment, when is it recommended to step down and with what strategy?
What is the treatment of choice as an added therapy in asthmatic children?
What is the effectiveness of SMART therapy in asthmatic children?
Educational interventions
What is the best written action plan for children with asthma: the symptom-based plan or the plan based on peak flow measurement?
What is the role of schools in the education and control of children with asthma?
Is peer tutoring effective in adolescents with asthma to improve disease control?
Is the educational intervention effective in children at high risk for emergency visits or hospital admission
As you can see, the Guide offers a broad approach to the disease. And although some issues are too far apart because of their specialization, certainly many others will directly affect families with children who suffer from it or schools and teachers. In these 21 questions about childhood asthma and your answers parents of children with asthma will also find help to control it in the best way.
