Abstracts from CIPP XVI Meeting Libon june 2017.pdf
CIPP XVI ABSTRACTS
#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
National Population-based Study in Taiwan.
Su YT 1, Tsai Y 1, Chuang CY
Golan Tripto I , Horwitz D , Kestenbom I , Chechik T ,
Dizitzer Y 4, Goldbart DA 1.
Department of Pediatrics, Pediatric Pulmonology Unit, Soroka University
Medical Center, Ben-Gurion University of The Negev − Beer Sheva, Israel;
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
Wheezing phenotypes in young children and their associations with
subsequent wheezing in later life have been reported; however, longitudinal
data based on physician-diagnosed asthma in early life are scant.
Patients’ adherence to medical treatment is a major problem in the
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
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
latent class analysis to identify asthma phenotypes, and multivariate
logistic regression to analyze risk factors for outcomes at 6 years of age.
A prospective interventional pilot study enrolling children aged
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
Three asthma phenotypes in the first 3 years of life contributed to the
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
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
Artiso L 1, Walker S 2, Fleming L 3, Bush A 3, Saglani S
Nagakumar P 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
Coaching asthmatic children via house visits was found to be
associated with higher asthma medication consumption, similar ER
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,