Evidence map›Paper›PMID 38539116›Full record

ArticleBMC pediatrics2024

Optimizing care for children with difficult-to-treat and severe asthma through specialist paediatric asthma centres: expert practical experience and advice.

M W Pijnenburg, S Rubak, H O Skjerven, S Verhulst, V Elenius, C Hugen, O Jauhola, C Kempeneers, E Melén, T Reier Nilsen and 6 more

Abstract read
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In one paragraph

Article in BMC pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

M W Pijnenburg *Department of Paediatrics, Division of Respiratory Medicine and Allergology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0003-0902-0860
S Rubak *Danish Center of Pediatric Pulmonology and Allergology, Department of Pediatrics and Adolescent Medicine, Department of Clinical Medicine, University Hospital of Aarhus, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-7010-2350
H O Skjerven *Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
S Verhulst *Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium.
V Elenius *Department of Pediatrics, Turku University Hospital, Turku, Finland.ORCID http://orcid.org/0000-0001-9264-9904
C Hugen *Department of Pediatrics, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-9449-9679
O Jauhola *Department of Allergology, Helsinki University Hospital, Helsinki, Finland.
C Kempeneers *Division of Respirology, Department of Pediatrics, University Hospital Liège, Liège, Belgium.
E Melén *Sachsska Children's Hospital and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
T Reier Nilsen *The Norwegian Olympic Sports Centre, Oslo, Norway.ORCID http://orcid.org/0000-0001-8184-0607
N W Rutjes *Department of Pediatric Pulmonology and Allergy, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-3996-1963
M Ruotsalainen *Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
H Schaballie *Pediatric Pulmonology, Pediatric Department, Ghent University Hospital, Ghent, Belgium.
A M Zwitserloot *Beatrix Children's Hospital Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
M ProesmansDepartment of Pediatrics, University Hospital Leuven, Leuven, Belgium.
M J MäkeläDepartment of Allergology, HUS, Helsinki University Hospital, Allergic Diseases and University of Helsinki, P.O. Box 160, FIN-00029, Helsinki, Finland. Mika.Makela@hus.fi.ORCID http://orcid.org/0000-0002-2933-3111

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Severe asthma in children carries an unacceptable treatment burden, yet its rarity means clinical experience in treating it is limited, even among specialists. Practical guidance is needed to support clinical decision-making to optimize treatment for children with this condition.This modified Delphi convened 16 paediatric pulmonologists and allergologists from northern Europe, all experienced in treating children with severe asthma. Informed by interviews with stakeholders involved in the care of children with severe asthma (including paediatricians, nurses and carers), and an analysis of European guidelines, the experts built a consensus focused on the gaps in existing guidance. Explored were considerations for optimizing care for patients needing biologic treatment, and for selecting home or hospital delivery of biologics. This consensus is aimed at clinicians in specialist centres, as well as general paediatricians, paediatric allergologists and paediatric pulmonologists who refer children with the most severe asthma to specialist care. Consensus is based on expert opinion and is intended for use alongside published guidelines.Our discussions revealed three key facets to optimizing care. Firstly, early asthma detection in children presenting with wheezing and/or dyspnoea is vital, with a low threshold for referral from primary to specialist care. Secondly, children who may need biologics should be referred to and managed by specialist paediatric asthma centres; we define principles for the specialist team members, tests, and expertise necessary at such centres, as well as guidance on when homecare biologics delivery is and is not appropriate. Thirdly, shared decision-making is essential at all stages of the patient's journey: clear, concise treatment plans are vital for patient/carer self-management, and structured processes for transition from paediatric to adult services are valuable. The experts identified the potential for specialist paediatric asthma nurses to play a significant role in facilitating multidisciplinary working.Through this project is agreed a framework of practical advice to optimize the care of children with severe asthma. We encourage clinicians and policymakers to implement this practical advice to enhance patient care.

Indexed as

AsthmaBiological ProductsAdultChildConsensusHumansReferral and ConsultationSpecializationBiological ProductsAsthma careAsthma nursesBiologicsChildrenDifficult-to-treat asthmaSevere asthma

Identifiers

PMID38539116
PMCPMC10967048

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.