Monitoring strategies in children with asthma: a randomised controlled trial.
Thorax
; 70(6): 543-50, 2015 Jun.
Article
em En
| MEDLINE
| ID: mdl-25825006
ABSTRACT
BACKGROUND:
Asthma guidelines recommend monitoring of asthma control. However, in a substantial proportion of children, asthma is poorly controlled and the best monitoring strategy is not known.OBJECTIVES:
We studied two monitoring strategies for their ability to improve asthma outcomes in comparison with standard care (SC) web-based monthly monitoring with the (Childhood) Asthma Control Test (ACT or C-ACT) and 4-monthly monitoring of FENO.METHODS:
In this randomised controlled, partly blinded, parallel group multicentre trial with a 1-year follow-up, children aged 4-18 with a doctor's diagnosis of asthma treated in seven hospitals were randomised to one of the three groups. In the web group, treatment was adapted according to ACT obtained via a website at 1-month intervals; in the FENO group according to ACT and FENO, and in the SC group according to the ACT at 4-monthly visits. The primary endpoint was the change from baseline in the proportion of symptom-free days (SFD).RESULTS:
Two-hundred and eighty children (mean age 10.4â years, 66% boys) were included; 268 completed the study. Mean changes from baseline in SFD were similar between the groups -2.1% (web group, n=90), +8.9% (FENO group, n=91) versus 0.15% (SC, n=87), p=0.15 and p=0.78. Daily dose of inhaled corticosteroids (ICS) decreased more in the web-based group compared with both other groups (-200â µg/day, p<0.01), while ACT and SFD remained similar.CONCLUSIONS:
The change from baseline in SFD did not differ between monitoring strategies. With web-based ACT monitoring, ICS could be reduced substantially while control was maintained. TRIAL REGISTRATION NUMBER NTR 1995.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Asma
/
Broncodilatadores
/
Budesonida
/
Glucocorticoides
/
Monitorização Fisiológica
Tipo de estudo:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Patient_preference
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Thorax
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Holanda