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Use of lung function tests in paediatric asthma care A nationwide registry study

Use of lung function tests in paediatric asthma care A nationwide registry study. Grete Moth, MHSc, Ph.D Danish Paediatric Asthma Centre Aarhus University Hospital, Skejby and Research Unit for General Practice University of Aarhus. Background.

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Use of lung function tests in paediatric asthma care A nationwide registry study

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  1. Use of lung function tests in paediatric asthma care A nationwide registry study Grete Moth, MHSc, Ph.D Danish Paediatric Asthma Centre Aarhus University Hospital, Skejby and Research Unit for General Practice University of Aarhus

  2. Background Insufficient treatment of asthmatic children > quality of life > hospitalisation > high public health expenditures Nationwide registries

  3. Aim To examine adherence to guidelines on use of lung function tests in paediatric asthma care - performance of the various care providers - risk of hospitalisation

  4. Methods I Danish Civil Registration System - the personal registration number Register of Medicinal Product Statistics - prescriptions of medicine Danish National Patient Registry - hospitalisations and visits to outpatient clinics National Health Insurance Service Registry - visits to GPs and primary care specialists Statistics Denmark - socioeconomic factors

  5. Methods I Study population: incident asthmatic children aged 6-14 Study period: 1999-2004

  6. Methods I • Provider of care: • GPs • Primary care specialists • Hospital specialists • GPs and specialists • Use of lung functions tests • - at start of medication • - during months 1-6 • - during months 7-12

  7. Results I 36.940 asthmatic children:

  8. Results I The good news: 5% - no lung function test at all The bad news: 9% - lung function tests as recommended

  9. Results I

  10. Results I

  11. Discussion Is there a problem? • Lack of adherence to guidelines by GPs • - but also by specialists • Appropriateness of the guidelines concerning use of lung function test

  12. Methods II • Exposure: • Lung function test at least once • - at start of medication • - months 1-6 • - months 7-12 Outcome: Risk of hospitalisation

  13. Results II

  14. Perspective Is there a problem? It seems so, but.. - Registry data are proxy outcome - Further research on patient centered outcome measures is needed If No >> guideline revision If Yes >> quality development

  15. Thank you for your attention!

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