[The Childhood Asthma Control Test improves the therapeutic adaptations recommended for asthmatics aged 6 to 11 years in primary practice. A Randomized comparative prospective study].

Autor: Perron G; Université de Montpellier, departement de medecine generale, Montpellier, France., Garcia M; Université de Montpellier, departement de medecine generale, Montpellier, France., Carbonnel F; Université de Montpellier, departement de medecine generale, Montpellier, France., Trebuchon F; CHU de Montpellier, centre médical, chemin de Fescau, 34980 Montferrier-sur-Lez, France., Daures JP; Laboratoire de biostatistique, d'épidémiologie et de sante publique, IURC, EA2415, Montpellier, France., Amouyal M; Université de Montpellier et équipe EPAR, departement de medecine générale, Paris, France., Demoly P; CHU, université de Montpellier et Sorbonne Université, Département de pneumologie & addictologie, UMR-S 1136, IPLESP, équipe EPAR, 75013 Paris, France. Electronic address: pascal.demoly@inserm.fr., Costa D; Université de Montpellier et équipe EPAR, departement de medecine générale, Paris, France.
Jazyk: francouzština
Zdroj: Presse medicale (Paris, France : 1983) [Presse Med] 2019 Sep; Vol. 48 (9), pp. e257-e266. Date of Electronic Publication: 2019 Aug 28.
DOI: 10.1016/j.lpm.2018.10.021
Abstrakt: Objectives: Asthma is the leading chronic disease of the child; control and treatment remain inadequate. Our objective was to assess whether the use of the Childhood Asthma Control Test (C -ACT) in primary care had an impact on adapting therapy.
Methods: The study was quantitative prospective and compared 2 groups of general practioners. All had the same reminders about childhood asthma management. The C-ACT was detailed to one group only. Doctors in the control group had to work as usual without C-ACT. Doctors included asthmatic children aged 6 to 11 years who were consulting for their asthma or any other reason. The primary endpoint was the adaptation of asthma treatment according to the Global Initative for Asthma (GINA). Evaluations of the control group were compared with the after consultation self-administered online C-ACT.
Results: From April to October 2014, 61 physicians included 179 patients in two comparable groups. Although not significant statistically, doctors using C-ACT found 45% of uncontrolled asthma (vs. 31%). When the reason for consultation was not related to asthma, the figure was 25% (vs. 15%). Doctors using the C-ACT made twice less therapeutic adaptations not recommended by the GINA: 8% vs. 16%. 25% of evaluations of doctors in the control group were discordant with the internet C-ACT. After correction with the internet C-ACT of these imprecise initial assessments, the figure was 25%: 3 times more than in the C-ACT group (P=0.014).
Conclusion: The use in primary care of C-ACT should allow a better assessment of asthma control and adaptation of treatment in children.
(Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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