title: Introduction of a new paediatric asthma guideline: Effects on asthma control levels.
abstract: In 2008, a new national paediatric asthma management guideline based on the international Global Initiative for Asthma (GINA) guideline was launched in the Netherlands. We studied whether asthma control and treatment regimens improved after introduction of the guideline by comparing survey data before and after the guideline introduction.
  
  
  
  Two comparable groups of children (6-16 years) with asthma were included before (2004) and after (2013) the introduction of the guideline. Children, parents and paediatricians completed questionnaires about asthma symptoms, medication and healthcare use. Spirometry was performed.
  
  
  
  Data of 209 patients were analysed. Level of asthma control did not improve between 2004 and 2013 with a proportion of (partly) controlled asthmatics of 51% in 2004 and 59% in 2013 (p = 0.28). In 2013, paediatricians characterized 76% of children as (partly) controlled, while 59% of children was (partly) controlled according to GINA criteria (p < 0.05). Step-down treatment in controlled patients was more applied by paediatricians in 2013 compared to 2004 (from 8 to 40%, p < 0.05). Step-up treatment in uncontrolled patients did not improve.
  
  
  
  Asthma control did not improve after the introduction of the new guideline. Compared to 2004, an improvement was observed in step-down treatment in patients with controlled disease.
authors.affiliation: Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: S C
authors.identifier: 0000-0002-2536-528X
authors.initials: SC
authors.lastname: Hammer
authors.affiliation: Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: L J H
authors.initials: LJH
authors.lastname: Sonneveld
authors.affiliation: Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: K D G
authors.initials: KDG
authors.lastname: van de Kant
authors.affiliation: Department of Paediatrics, Vie Curi Hospital, Venlo, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Hendriks
authors.affiliation: Department of Paediatrics, Orbis Medical Centre, Sittard, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Heynens
authors.affiliation: Department of Paediatrics, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Droog
authors.affiliation: Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Dompeling
authors.affiliation: Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: Q
authors.initials: Q
authors.lastname: Jöbsis
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009426:Netherlands; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D013147:Spirometry; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: asthma; asthma control; asthma treatment; guideline; outpatient clinic; paediatrician