Wheezy Child Program: The Experience of the Belo Horizonte Pediatric Asthma Management Program

World Allergy Organization Journal

Paulo Camargos¹  Ana Cristina Fonseca¹  Maria Teresa Mohallen¹  Maria Jussara Fontes¹  Laura Lasmar¹ 

[1] Pediatric Pulmonology Unit, University Hospital, and Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil; Wheezy Child Program, Municipal Health Authority, Belo Horizonte, Brazil

关键词: health services;    adolescents;    children;    asthma program;   

Others  :  1180816
DOI  :  10.1097/WOX.0b013e3181c6c8cb

【 摘 要 】

Background

Until 1994, assistance provided by the Municipal Public Health System to children with asthma in Belo Horizonte, Brazil, was ineffective because it focused only on treating exacerbations. This scenario motivated the implementation of the Wheezy Child Program.

Objectives

The main objectives were to reduce emergency room visits and hospitalizations.

Methods

The strategies adopted were as follows: continued medical education for pediatricians, reorganization of public assistance into different levels of complexity regarding asthma care, and free dispensation of inhaled beclomethasone, albuterol, and valved spacers. A partnership between the Pediatric Pulmonology staff of the Federal University of Minas Gerais and the Belo Horizonte Municipal Health Authority made these strategies come to fruition, especially through the training of health workers and the devising of protocol after GINA guidelines.

Results

Of 2149 patients with a history of hospitalization after program admission, only 453 were re-admitted in the 6 to 12 months after, a reduction of 79%. There was a 300% increase in the use of aerosol and a reduction to 50% in the use of oxygen-driven nebulizers (P < 0.001) in the management of exacerbations. For patients enrolled in the program with moderate and severe persistent asthma, the median adherence rate was 50%.

Conclusions

The Wheezy Child Program has significantly reduced hospitalizations and emergency room visits, has improved quality of life, and has shown that programs of this kind are feasible in low- to middle-income countries. More than 30,000 children have been assisted by the program, and now it seeks to optimize asthma control and increase adherence rates.

【 授权许可】

   
2009 World Allergy Organization; licensee BioMed Central Ltd.

【 图 表 】

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