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TOPLINE
In primary care, nurse-led protocolled care significantly improved asthma control in children aged 6-12 years, according to a study.
METHODOLOGY
- Researchers conducted a multicenter cluster randomized controlled trial of 90 children aged 6-12 years with asthma across 49 general practices in the Netherlands. The median follow-up was 18 months.
- Practices were randomized to protocolled nurse-led care (n = 51) or usual care (n = 39). Practice nurses received training and a written asthma-management protocol based on 2 national guidelines.
- Childhood Asthma Control Test (C-ACT) score was the primary outcome. Secondary outcomes included quality of life, satisfaction with care, frequency and severity of exacerbations, forced expiratory volume in 1 second (FEV1), forced expiratory flow at 75% of vital capacity, uncontrolled asthma, spirometry, medication use, and parental satisfaction.
- Children in the protocolled-care group received a 40-minute baseline visit with a practice nurse, followed by visits scheduled according to asthma control under Global Initiative for Asthma criteria.
TAKEAWAY
- C-ACT scores were significantly higher with protocolled care at 18 months (P = .045). The median number of visits was two.
- Uncontrolled asthma was less common with protocolled care (6.5%) compared with usual care (6.5% vs 22.2%; P = .038).
- ICS use increased slightly with protocolled care and decreased with usual care, while SABA overuse decreased with protocolled care and increased with usual care (P = .024 and P = .027, respectively). Other secondary outcomes did not differ significantly between groups.
IN PRACTICE
"This study showed protocolled nurse-led care for children with asthma aged 6-12 years in primary care to improve asthma control with an acceptable number of review visits," the authors wrote.
SOURCE
The study was led by Sara Bousema, Department of General Practice, University Medical Centre Rotterdam, Rotterdam, Netherlands. It was published online on August 24 in ERJ Open Research.
LIMITATIONS
The study was underpowered for secondary outcomes, asthma diagnoses were not confirmed by spirometry, and vaping and BMI data were unavailable.
DISCLOSURES
This study was supported by The Netherlands Organization for Health Research and Development (ZonMw). The authors reported no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
