How pediatricians in Spain manage the first acute wheezing episode in an atopic infant. Results from the TRAP study
| Autor: | A. Escribano Montaner, Jose A. Castro-Rodriguez, J. Pellegrini Belinchon, J.J. Morell Bernabé, J. Garde Garde, Luis Garcia-Marcos |
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| Rok vydání: | 2005 |
| Předmět: |
Pulmonary and Respiratory Medicine
Hypersensitivity Immediate Allergy Pediatrics medicine.medical_specialty Immunology Adrenergic beta-Antagonists Administration Oral Primary care Maintenance therapy Adrenal Cortex Hormones Adrenergic beta-2 Receptor Antagonists Recurrence Surveys and Questionnaires Administration Inhalation medicine Immunology and Allergy Humans Respiratory sounds Anti-Asthmatic Agents Metered Dose Inhalers Family history Practice Patterns Physicians' Asthma Respiratory Sounds medicine.diagnostic_test Bronchial Spasm business.industry Inhaler Data Collection Masks Infant General Medicine medicine.disease Spain Child Preschool Oral steroid Acute Disease Practice Guidelines as Topic Drug Therapy Combination Guideline Adherence business Case Management Inhalation Spacers |
| Zdroj: | Allergologia et immunopathologia. 33(6) |
| ISSN: | 0301-0546 |
| Popis: | Background Although the treatment of asthma has been addressed in several guidelines, the management of the first acute wheezing episode in infants has not often been evaluated. We surveyed practicing pediatricians in Spain about the treatment they would provide in a simulated case. Material and methods A random sample of 3000 pediatricians and physicians who normally treated children was surveyed. The questionnaire inquired about how they would treat a first mild-to-moderate wheezing attack in a 5-month-old boy with a personal and family history of allergy. Pediatricians were asked about their professional background. Results A total of 2347 questionnaires were returned with useful data (78.2 %). Most (90.4 %) of the pediatricians would use a short-acting beta2 - agonist (SABA) via a metered-dose inhaler with a spacer and a face mask or nebulizer. However, only 34.5 % chose a SABA alone: 31.3 % added an oral steroid and 27.6 % added an inhaled corticosteroid (ICS). The factors associated with the use of ICS in the acute attack were: (1) lack of specific training in pediatrics (OR 1.45; 1.12-1.85) and (2) primary care health center setting (OR 1.31; 1.01-1.69) or rural setting (OR 1.28; 1.01-1.66). Forty-four percent did not recommend any follow-up treatment while 20.7% prescribed ICS as maintenance therapy. The factors related to this decision were the same as those described above. Conclusions The management of a first wheezing episode seems to meet published guidelines among Spanish pediatricians with formal training in pediatrics and in those who work in a hospital setting or in urban areas. |
| Databáze: | OpenAIRE |
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