Diagnostic therapeutic educational pathway

1° visit cover:

• Family history of atopy, asthma, allergic rhinitis and smoking habit, neonatal and perinatal history (focusing on prematurity, allergies or airway diseases)
• Remote history of airway diseases and recent history of symptoms potentially causing or correlated with asthma (dry or productive cough, resting or exercise-induced wheezing, bronchospasm, waking at night due to coughing, chest tightness, rhinorrhea, nasal obstruction, conjunctivitis, atopic dermatitis)
• In addition, we recorded treatment provided for  attacks of bronchoconstriction, any complications (paying particular attention to the effect on symptoms of bronchodilators); past or present maintenance treatment (drug and dosage frequency,  system of administration and any adverse effects, any utilization of emergency service and/or hospitalization
• Lung function measurement and/or skin prick tests are performed
• Assessment of asthma severity by clinical features before treatment 

• Report 
   
• Short course for parents
   
• Information cards for parents
   
• Web site 
   
• Audit 

2° Visit (after 6/8 weeks):

• To ckeck carefully the approval and adoption of the treatment plan by the primary care physician
• To ckeck and assess the compliance of patient’s and family with the treatment, the frequency and severity of the symptoms following the levels of asthma control
• Response to any bronchodilators used for acute attacks is also evaluated, through the diary card, as are the benefits and side effects of any maintenance therapy adopted
• Lung function measurement and/or skin prick tests are performed if necessary
• Reassessment of diagnosis/therapy

•  Report 
   
• Information Cards for Children 
   
• Educational Video Games 
   
• Information Cards for Teachers 
   
• Administration drugs at school: The protocol
   
• Educational Videos 
   
• Phone Support 
    
• Audit 

3° visit (after 6/8 weeks): 

• The approval and adoption of the treatment plan by the primary care physician is checked carefully
• To reassess and adjust the severity following the levels of asthma control and consequently also the treatment in the light of any reported changes in asthma symptoms, in the frequency of the need to use bronchodilators for an acute episode
• The patient’s compliance with the treatment program and correct use of medication and the devices for its administration are ascertained
• Lung function measurement and/or Skin Prick Tests are performed if necessary
• Difficult management: educational courses for parents and children
• Discharge primary care follow-up with a dedicated section in the report

•  Report 
   
• Educational courses for parents and children 
   
• Technical and social support by ALCPeRB  (parents association)
   
• Phone Support 
   
• Audit 

Follow-up (after 6 months) dedicated to:
 -patient discarged
 -patient with controller / maintenance therapy

Follow-up (after 6 months) for two times dedicated to:
 -patient with intermittent asthma
 -patient with intermittent asthma after controller / maintenance therapy

Follow-up (after 1 year) dedicated to:
 -patient with intermittent asthma
 -patient with intermittent asthma after controller / maintenance therapy

• The approval and adoption of the treatment plan, visits and/or phone interview  by the primary care physician is checked carefully
• Assessment of patient’s and family’s compliance, frequency and severity of  symptoms and therapies  following the levels of asthma control
• Lung function measurement are performed
• Skin Prick Tests are performed  if necessary
• Reassessment of diagnosis/therapy
• Reinforcement of the asthma information training
• Difficult management: visit after 6/8 weeks and/or educational courses for parents and children
• Discharge,  primary care follow-up with a dedicated section in the report 

• Report / Phone interview 
   
• Web site 
   
• Phone Support 
   
• Audit