Are International Asthma Guidelines effective for low-income Brazilian children with asthma?
The present study was designed to evaluate the effectiveness of International Asthma Guidelines in low-income asthmatic children in the city of São Paulo, Brazil. Fifty children with moderate or severe asthma were evaluated. Patients were evaluated before and after a 1 yr follow-up period using a pre- and post-education design with patients acting as their own controls. Parents were interviewed before and 1 yr after the programme. Most of the children were receiving inadequate medical care from their primary physicians, based mainly on bronchodilators. After the educational programme combined with a medical treatment based mainly on inhaled steroids, there was a decrease in emergency room visits and no need for hospital admissions. There was also a significant decrease in asthma severity and impairment scores (p<.0001). The combination of good medical care and an educational programme can reduce the symptoms of asthma and significantly increase the quality of life, as well as decreasing the costs of asthma treatment. We conclude that by applying the International Asthma Guidelines substantial success was achieved, resulting in moving the patients from crises-orientated management into a chronic care and preventive management mode.
Darcy Vargas Hospital, and Dept of Medicine, Faculty of Medicine, University of São Paulo, SP, Brazil.
A L
AL
Cabral
W A
WA
Carvalho
M
M
Chinen
R M
RM
Barbiroto
F M
FM
Boueri
M A
MA
Martins
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001249:Asthma / Q000534:rehabilitation*; D001938:Brazil; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D003906:Developing Countries; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007391:International Cooperation; D008297:Male; D010290:Parents / Q000193:education*; D011203:Poverty; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D014505:Urban Population
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents