Abstract
Background: In 2008, a new national asthma management guideline based on the international GINA guidelines was launched in the Netherlands, aiming to improve asthma control in the paediatric population. We studied whether the level of asthma control and treatment regimens were improved by comparing data of 2004 with the actual situation.Methods: Two comparable groups of children aged 6-16 years with an asthma diagnosis for at least 6 months, were randomly selected from the outpatient clinic of four hospitals in the Netherlands in 2004 and in 2013. Patients and pediatricians completed questionnaires about asthma symptoms, medication and healthcare use. Lung function tests were performed.Results: In total, 112 asthmatic children were included in 2004 and 97 asthmatic children in 2013. The level of asthma control did not improve between 2004 and 2013 (proportion of (partly) controlled asthmatic children in 2004: 51%, and in 2013: 59%, p=0.28). Paediatricians indicated 87% of all children as having (partly) controlled asthma, which was significantly higher than 59% of the children with (partly) controlled according to GINA criteria (p<0.05) Most children (88%) perceived their asthma as (partly) controlled. Step down treatment was more applied in controlled patients (from 8 to 40%, p<0.05). In contrast, in uncontrolled patients step-up therapy was not applied more frequently (22% vs. 23% respectively, p>0.05).Conclusions: Asthma control did not significantly improve after introduction of new asthma guidelines. Patients perceive their asthma control level more optimistic than their paediatricians, though they both still overestimate asthma control when compared to the GINA criteria.