Abstracts from CIPP XVI Meeting Libon june 2017.pdf


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CIPP XVI ABSTRACTS

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S105

#A103 − Coaching via House Visits in Asthmatic Children

A141 − Asthma Phenotypes in the First Three Years of Life

and Their Effect on Respiratory Morbidity and Health Care

and Correlation with Active Asthma at 6 Years of Age: A

Utilization.

National Population-based Study in Taiwan.
1

2

3

3

Su YT 1, Tsai Y 1, Chuang CY

Golan Tripto I , Horwitz D , Kestenbom I , Chechik T ,
Dizitzer Y 4, Goldbart DA 1.

2

1

1

Department of Pediatrics, Pediatric Pulmonology Unit, Soroka University
Medical Center, Ben-Gurion University of The Negev − Beer Sheva, Israel;
2
Faculty of Health Sciences, Ben-Gurion University of the Negev − Beer-Sheva,
Israel; 3Department of Pediatrics, Soroka University Medical Center − BeerSheva, Israel; 4Clinical Research Center, Soroka University Medical Center −
beer- Sheva, Israel

Division of Pediatric Pulmonology and Allergy-Immunology, Department Pediatrics, E-Da Hospital/I-Shou University − Kaohsiung City, Taiwan; 2School of
Chinese Medicine for Post-Baccalaureate, I-Shou University − Kaohsiung, Taiwan

Background
Wheezing phenotypes in young children and their associations with
subsequent wheezing in later life have been reported; however, longitudinal

Background

data based on physician-diagnosed asthma in early life are scant.

Patients’ adherence to medical treatment is a major problem in the

Objective

management of chronic diseases such as asthma. Non-adherence
to asthma medications is associated with frequent emergency
room visits, hospitalizations and use of oral corticosteroids. The

To identify asthma phenotypes in the first 3 years of life, and to
investigate their associations with active asthma at 6 years of age.

aim of the study is to assess whether coaching asthmatic children

Methods

via house visits will improve adherence to medical regimens and

Children with physician-diagnosed asthma in the first 36 months and at

therefore will reduce respiratory morbidity and health care

6 years were studied in a national population-based cohort. We used

utilization.

latent class analysis to identify asthma phenotypes, and multivariate

Methods

logistic regression to analyze risk factors for outcomes at 6 years of age.

A prospective interventional pilot study enrolling children aged

Results

3–18 years, admitted to the Soroka Medical Center between

From 2000 to 2011, 5013 children had physician-diagnosed asthma in

October 2015 and May 2016 due to asthma exacerbation

the first 36 months, 1055 of whom had active asthma at 6 years of age.

(intervention group). During one year of follow up, the children

Three asthma phenotypes were identified: transient early (34.9%),

were coached by a Pediatric Pulmonologist in the clinic and by a

late-onset (45.4%), and persistent (19.8%). Among these phenotypes,

highly trained nurse in house visits. The control group included

gender, age at first episode, number of asthma episodes in the 1st, 2nd,

asthmatic children who were admitted during the same time

and 3rd years, total number of asthma episodes, coincidental allergic

period, but did not go through any intervention. Medication

rhinitis, and atopic dermatitis were all significantly different. The

purchase and health care utilization were extracted from the

prevalence of active asthma at 6 years of age was 13.6% in the

‘Clalit’ HMO databases. Asthma control was assessed through

transient early, 24.3% in the late-onset (OR = 2.038, p<0.05), and

self − questionnaires (Asthma Control Test™ (age 12–18) and

26.6% in the persistent (OR = 2.299, p<0.05) group.

Childhood Asthma Control Test* (age 3–12) in the intervention

Conclusion

group.

Three asthma phenotypes in the first 3 years of life contributed to the

Results

natural course of pediatric asthma. Based on high risk of subsequent

The intervention group included 42 children (mean age 7

asthma at 6 years of age, the children in late-onset and persistent

years ± 3

asthma phenotypes may need aggressive treatment to prevent

months)

and

the

control

group

included

212

children (mean age 7 years ± 4 months). The intervention group

persistent airway illnesses.

consumed significantly more asthma medications, controllers and
relievers (median 6.5, IQR 3–13), when compared to the control

#A154 − Sputum Eosinophil Peroxidase (EPX)

group (median 4, IQR 2–9, p-value 0.023). There was no

Differentiates Pediatric Severe Therapy Resistant Asthma

significant difference in the amount of clinic visits, ER

(STRA) from Difficult Asthma (DA).

visits and hospitalizations, attributed to respiratory symptoms,
between the two groups. There was a significant improvement in
the subjective feeling of asthma control, as reflected from
the questionnaires, filled before and after the intervention
(p-value<0.001).
Conclusion

Artiso L 1, Walker S 2, Fleming L 3, Bush A 3, Saglani S
Nagakumar P 2,3.

2,3

,

Respiratory Paediatrics, Royal Brompton Hospital − London, United Kingdom;
Inflammation, Repair and Development, National Heart and Lung Institute,
Imperial College − London, United Kingdom; 3Respiratory Paediatrics, National
Heart and Lung Institute, Imperial College and Royal Brompton Hospital −
London, United Kingdom
1
2

Coaching asthmatic children via house visits was found to be
associated with higher asthma medication consumption, similar ER

Background

visits & hospitalizations and an improved subjective feeling, as

Children with STRA have poor control despite maximal therapy

reflected from ACT questionnaires.

and having ensured modifiable factors, such as poor adherence,