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Fifteen-minute consultation: An evidence-based approach to the child with preschool wheeze
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  • Published on:
    Patient reported outcome measures as important tool for the non pharmacological management of preschool children with recurrent wheeze
    • Heidi Makrinioti, paediatric trainee MD, PhD
    • Other Contributors:
      • Robert Klaber, consultant paediatrician and associate medical director
      • Mando Watson, consultant paediatrician

    Preschool recurrent wheeze affects many children in the UK and causes great strain in their families (1). The pharmacological management during the acute episodes of wheeze offers significant relief. However, the evidence around the maintenance therapy is not conclusive.
    The majority of these children grow out of the condition. The current pharmacological treatment though has not been shown to change the natural course of the disease (2, 3). Therefore, it could be argued that addressing the actual concerns of their parents/carers should be the focus that makes a significant difference to their everyday lives.
    Defining personalised outcomes for preschool children with recurrent wheeze requires an understanding of what really matters for these families. A major step towards an efficient treatment would then involve reaching these outcomes and a measurement tool could monitor this.
    Asthma Action Plans for children with a diagnosis of asthma have been shown to reduce the rates of hospital admissions, emergency department visits and school absence rates (4). In Australia, the introduction of a personalised wheeze action plan shows the potential to reduce the treatment with corticosteroids and to improve the education of these families around acute management but this is not clear as to whether this is related to a decrease in emergency department admissions (5).
    Although education and management plans are an important part of the non-pharmacological mana...

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    Conflict of Interest:
    None declared.