Author(s): Marita Paassilta, Hanna Kerminen, Matti Korppi
Finnish current care guidelines recommend that the treatment of asthma in young children should be based on the number of wheezing episodes and on the assessment of asthma risk profile consisting of two major and three minor criteria, constructed on the basis of the international asthma predictive index. The aim of the present study was to assess whether the current guidelines and risk profile determination are applied in the treatment of asthma in children aged less than three years. In all, 179 children aged 1-35 months were admitted for wheezing during four winter-months from 1st Nov, 2006 to 28th Feb. 2007. The data on treatment decisions, and major and minor asthma risk factors were retrospectively collected from patient records. Recorded data sufficient for the retrospective determination of the asthma risk profile were found for 112/179(63 %) children. Data on minor criteria were missing in almost all cases. Most of the children with data not available were first-time wheezers. Twenty-one children (19%) were on maintenance medication at admission. The decision whether or not to start maintenance medication was in line with the current care guidelines in 76/91(84 %) children. In conclusion, the treatment of asthma in young children mostly took place according to the national current care guidelines, though the application of the asthma risk profile was insufficient. The minor criteria of the asthma risk profile are not sufficiently sensible for clinical practice, and therefore need to be up-to-dated.