National and regional asthma programmes in Europe.
This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.
Selroos Medical Consulting (Semeco AB), Ängelholm, Sweden olof.selroos@telia.com.
Olof
O
Selroos
Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
Maciej
M
Kupczyk
Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
Piotr
P
Kuna
Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
Piotr
P
Łacwik
National Institute for Health and Medical Research (INSERM), Paris, France.
Jean
J
Bousquet
European Federation of Asthma and Airways Diseases Patients' Association (EFA), Brussels, Belgium.
David
D
Brennan
European Federation of Asthma and Airways Diseases Patients' Association (EFA), Brussels, Belgium.
Susanna
S
Palkonen
National Federation of Respiratory Disease Associations (FENAER), Malaga, Spain.
Javier
J
Contreras
Institute for Heart and Lung Health, Vancouver, Canada.
Mark
M
FitzGerald
Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
Gunilla
G
Hedlin
Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, UK.
Sebastian L
SL
Johnston
Dept of Pneumology, CHU Sart-Tilman Liège, Liège, Belgium.
Renaud
R
Louis
Asthma UK, London, UK.
Leanne
L
Metcalf
Asthma UK, London, UK.
Samantha
S
Walker
Pediatric Pulmonology Unit, Hospital Vall d'Hebron, Barcelona, Spain.
Antonio
A
Moreno-Galdó
Dept of Allergology, University of Athens, Athens, Greece.
Nikolaos G
NG
Papadopoulos
Immunoallergology Dept, Hospital da Luz, Lisbon, Portugal.
José
J
Rosado-Pinto
European Lung Foundation, Sheffield, UK.
Pippa
P
Powell
Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Tari
T
Haahtela
D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration / Q000592:standards; D017410:Practice Guidelines as Topic; D016730:Program Development; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012040:Regional Health Planning / Q000458:organization & administration / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome