Objective confirmation of asthma diagnosis, treatment adherence and patient outcomes in children and adolescents

2021 ◽  
Author(s):  
LK Aarestrup ◽  
MN Hermansen ◽  
J Prahl ◽  
KS Hansen ◽  
BL Chawes
Keyword(s):  
Children And Adolescents ◽  
Treatment Adherence ◽  
Patient Outcomes ◽  
Asthma Diagnosis

scholarly journals Stigma and cystic fibrosis

2010 ◽  
Vol 18 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Tainá Maues Peluci Pizzignacco ◽  
Débora Falleiros de Mello ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Chronic Disease ◽  
Children And Adolescents ◽  
Treatment Adherence ◽  
Family Relationships ◽  
Life Histories ◽  
Autosomal Recessive ◽  
Family Members

Cystic Fibrosis (CF), also known as Mucoviscidosis, is a chronic disease of autosomal recessive origin and so far incurable. This analysis considers some characteristics of patients and family members that indicate it is a stigmatizing disease. The CF stigma’s impact on the lives of children and adolescents can affect treatment adherence, socialization, family relationships and the formation of their life histories, with direct consequences on their quality of life.

scholarly journals Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053100
Author(s):  
Reratilwe Ephenia Mphahlele ◽  
Omolemo Kitchin ◽  
R Masekela
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Control Test ◽  
Asthma Diagnosis ◽  
Asthma Control Test ◽  
Eligibility Criteria ◽  
Asthma Control Questionnaire ◽  
African Children

ObjectiveTo identify reasons for poor asthma control in African children and adolescents.DesignSystematic reviewData sourcesPubMed, Scopus, CINHAL, PsycINFO, MEDLINE and Web of Science databases were systematically searched up to 31 May 2020. Hand searching was done on Sabinet, African Journal online and Google Scholar.Eligibility criteriaStudies identifying barriers to asthma control, where asthma control was assessed by the validated Asthma Control Test/Child Asthma Control Test and/or Asthma Control Questionnaire were included.Data extraction and synthesisTwo reviewers independently selected studies for inclusion with disagreements resolved by a research team discussion, including a third reviewer. Data were extracted using the Cochrane Effective Practice and Organization of Care data collection form. The quality of the included studies was assessed using the modified Newcastle-Ottawa quality assessment scale. Identified barriers were reported in a thematic narrative synthesis.Primary outcomesPoorly controlled asthma and associated factors.ResultsFrom 914 records, three studies conducted between 2014 and 2019 in Nigeria, Uganda and South Africa met the inclusion criteria. A total of 883 children aged 4–19 years were analysed. Older age, concurrent allergy and city-dwelling significantly impacted asthma control. Few children with asthma symptoms in the community had ever used inhaled corticosteroids (6.7%) and identified reasons included lack of asthma diagnosis (38.8%) and no prescribed treatment (47.6%).ConclusionAsthma control in African children is impacted by age, allergy, urbanisation and lack of access to asthma diagnosis and treatment. More studies focusing on identifying barriers to asthma control in Africa are needed.PROSPERORegistration no: CRD42020196755)

Outcomes in Children and Adolescents With Psychogenic Nonepileptic Events Using a Multidisciplinary Clinic Approach

2020 ◽  
Vol 35 (13) ◽  
pp. 918-923 ◽  
Author(s):  
Debbie Terry ◽  
Laurie Enciso ◽  
Kristen Trott ◽  
Maggie (Mary) Burch ◽  
Dara V. F. Albert
Keyword(s):  
Social Work ◽  
Children And Adolescents ◽  
Clinical Improvement ◽  
Patient Outcomes ◽  
Care Coordination ◽  
Epileptic Seizures ◽  
Coordination Of Care ◽  
Multidisciplinary Clinic ◽  
Prospective Database

Background: Psychogenic nonepileptic events (PNEE) are paroxysmal events that resemble epileptic seizures but are caused by psychological factors. Coordination of care has been recommended as one strategy to integrate care and improve outcomes. We aim to evaluate patient outcomes in a multidisciplinary pediatric psychogenic nonepileptic events clinic that includes care coordination. Methods: All patients referred to the multidisciplinary psychogenic nonepileptic events clinic were entered into a prospective database. Follow-up calls were made by the clinic nurse at 1 and 3 months following the visit. Results: A total of 101 unique patients were reviewed. Ninety-six appointments were scheduled, and 83 appointments were completed (86%). Social work identified barriers in 38 patients, and 76% of those assisted completed their appointment. At 1 month, two-thirds of families were reached, 50% were accepting of the diagnosis, and 70% had clinical improvement in events. By 3 months, 75% had clinical improvement, 76% were receiving mental health services, and 73% were accepting of the diagnosis; however, more had also returned to the emergency department. Families needing assistance from social work tended to have worse outcomes. Increase in acceptance was nearly statistically significant ( P = .058) from 1 to 3 months; however, it was not so for clinical improvement in events ( P = .623). Conclusions: Implementation of a multidisciplinary team with care coordination allowed for follow-up for children and adolescents with psychogenic nonepileptic events and mitigation of barriers to care and can improve clinical outcomes. After being seen in our clinic, many families had accepted the diagnosis, most of the patients reached had event improvement and were successfully linked with counseling at the 1- and 3-month follow-ups.

Realtime Continuous Glucose Monitoring in Children and Adolescents— An Overview of the Current Technology and its Impact on Patient Outcomes

2012 ◽  
Vol 08 (01) ◽  
pp. 30
Author(s):  
Jeniece Trast ◽  
Neesha Ramchandani ◽  
◽  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Patient Outcomes ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Age Groups ◽  
Glucose Monitoring ◽  
Parental Satisfaction ◽  
Patient Use

Continuous glucose monitoring (CGM) systems, available for patient use since 1999, and realtime continuous glucose monitoring (RT-CGM) systems, available since 2006, have helped optimize diabetes management. Previously, RT-CGM studies found benefits mainly in patients with type 1 diabetes over the age of 25. Children and adolescents often present a challenge when managing type 1 diabetes. However, it is now apparent that RT-CGM has clear benefits in these age groups as well as in adults. Not only have studies shown improvements in glycemic control in this population, they have also demonstrated parental satisfaction with the technology. Challenges with RT-CGM use still exist and must be addressed. Nevertheless, RT-CGM is a beneficial tool to assist in diabetes management, and its use should be encouraged in the majority of pediatric patients with type 1 diabetes.

scholarly journals Can Treatment Adherence Be Improved by Using Rubin's Four Tendencies Framework to Understand a Patient's Response to Expectations

2017 ◽  
Vol 2 (Suppl. 1) ◽  
pp. 1-12
Author(s):  
Jeremy Kirk ◽  
Anita MacDonald ◽  
Paul Lavender ◽  
Jessica Dean ◽  
Gretchen Rubin
Keyword(s):  
Treatment Adherence ◽  
Patient Outcomes ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Treatment Plan ◽  
Patient Specific ◽  
Call To Action ◽  
Specific Strategy ◽  
Key Factor ◽  
Plan Movement

Within the context of poorer patient outcomes and rising healthcare costs, we need to better understand why many patients do not engage fully with their treatment plan. Movement away from talking about “compliance” towards “adherence” and “concordance” is evidence of a recognition that this is a two-way process. Whilst healthcare professionals expect patients to engage in treatment, equally, patients have expectations (whether positive or negative) of their treatment and their need for engagement. There is a need for an effective method that can specifically target those interventions that will provide the most benefit to individual patients and which, crucially, is easy and inexpensive to administer in everyday practice and widely applicable. Rubin's Four Tendencies model identifies a patient's “response to outer and inner expectations” as a key factor in adherence. The model therefore provides an opportunity to test such a targeted, patient-specific strategy and we present a call to action for research in this area.

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