title: The 'unified airway': the RCPCH care pathway for children with asthma and/or rhinitis.
abstract: OBJECTIVE
  The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies: the asthma/rhinitis care pathway is the third such pathway. Asthma and rhinitis have been considered together. These conditions co-exist commonly, have remarkably similar immuno-pathology and an integrated management approach benefits symptom control.
  
  
  METHODS
  The asthma/rhinitis pathway was developed by a multidisciplinary working group and was based on a comprehensive review of evidence. The pathway was reviewed by a broad group of stakeholders including the public and was approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee.
  
  
  RESULTS
  The pathway entry points are defined by symptom type and severity at presentation. Acute severe rhinitis and life-threatening asthma are presented as distinct entry routes to the pathway, recognising that initial care of these conditions requires presentation-specific treatments. However, the pathway emphasises that ideal long term care should take account of both conditions in order to achieve maximal improvements in disease control and quality of life.
  
  
  CONCLUSIONS
  The pathway recommends that acute presentations of asthma and/or rhinitis should be treated separately. Where both conditions exist, ongoing management should address the upper and lower airways. The authors recommend that this pathway is implemented locally by a multidisciplinary team (MDT) with a focus on creating networks. The MDT within these networks should work with patients to develop and agree on care plans that are age and culturally appropriate.
authors: Paediatric Allergy, Great North Children's Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK. gillian.vance@nuth.nhs.uk
authors: Gillian
authors: G
authors: Vance
authors: Kate
authors: K
authors: Lloyd
authors: Glenis
authors: G
authors: Scadding
authors: Samantha
authors: S
authors: Walker
authors: Fiona
authors: F
authors: Jewkes
authors: Lynette
authors: L
authors: Williams
authors: Lisa
authors: L
authors: Dixon
authors: Claire
authors: C
authors: O'Beirne
authors: Penny
authors: P
authors: Fletcher
authors: Trevor
authors: T
authors: Brown
authors: Jenny
authors: J
authors: Hughes
authors: Dalbir
authors: D
authors: Sohi
authors: Cher
authors: C
authors: Piddock
authors: Michael
authors: M
authors: Shields
authors: Michael
authors: M
authors: McKean
authors: John
authors: J
authors: Warner
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D019091:Critical Pathways / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011369:Professional-Patient Relations; D012220:Rhinitis / Q000628:therapy*; D012720:Severity of Illness Index; D012955:Societies, Medical; D006113:United Kingdom