- Title
- Clinical and lung function outcomes in a cohort of children with severe asthma
- Creator
- de Gouveia Belinelo, Patricia; Nielsen, Aleisha; Pearce, Kasey; Murphy, Vanessa E.; Gibson, Peter G.; Collison, Adam; Mattes, Joerg; Goddard, Bernadette; Platt, Lauren; Da Silva Sena, Carla Rebecca; Robinson, Paul D.; Whitehead, Bruce; Hilton, Jodi; Gulliver, Tanya; Roddick, Laurence
- Relation
- BMC Pulmonary Medicine Vol. 20, no. 66
- Publisher Link
- http://dx.doi.org/10.1186/s12890-020-1101-6
- Publisher
- BMC
- Resource Type
- journal article
- Date
- 2020
- Description
- Background: Uncontrolled severe asthma in children is burdensome and challenging to manage. This study aims to describe outcomes in children with uncontrolled severe asthma managed in a nurse-led severe asthma clinic (SAC). Methods: This retrospective analysis uses data collected from children referred by a paediatric respiratory specialist to a nurse-led SAC for uncontrolled severe asthma between 2014 and 2019. The pre-clinical assessments included a home visit to assess modifiable factors that could be addressed to improve control. A comprehensive lung function analysis was conducted at each visit. Interventions were personalised and included biologic agents. Statistical analysis was performed using nonparametric, two-tailed Mann-Whitney U-test, the parametric Student’s t-test, or analysis of variance (ANOVA) as appropriate. Results: Twenty-three children with a median age of 12 years were seen once, and 16 were followed up. Compared to a non-asthmatic (NA) and asthmatic (A) age-matched cohort, children with severe asthma (SA) had a lower FEV1, and FVC% predicted before and after bronchodilator inhalation, and a higher mean Lung Clearance Index [LCI] (10.5 [SA] versus 7.3 [NA] versus 7.6 [A], p = 0.003). Almost 80% of children with SA had an abnormal LCI, and 48% had a reduced FEV1% at the first SAC visit. Asthma control and FEV1% predicted significantly improved at a follow-up visit, while LCI remained abnormal in the majority of children (83%). Conclusion: Over time, many children with severe asthma showed improved clinical outcomes and lung function while lung ventilation inhomogeneities persisted. Future appropriately controlled studies are required to determine if a nurse-led multidisciplinary SAC is associated with better outcomes.
- Subject
- severe asthma; lung function; multidisciplinary clinic; childhood asthma
- Identifier
- http://hdl.handle.net/1959.13/1423801
- Identifier
- uon:37978
- Identifier
- ISSN:1471-2466
- Rights
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Language
- eng
- Full Text
- Reviewed
- Hits: 5994
- Visitors: 6220
- Downloads: 241
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 540 KB | Adobe Acrobat PDF | View Details Download |