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Master Thesis

État des lieux de la prise en charge ambulatoire de l'asthme de l'enfant en Guadeloupe

Abstract : Introduction : Asthma is the most common chronic disease in children, causing a high volume of emergency department consultations. Objectives : The aim of this study was to assess pediatric asthma management in primary care in Guadeloupe, in comparison with international and French guidelines so that standardised clinical guidelines could be proposed. Material and Methods : This is an observational descriptive study, including 19 pediatricians and 42 sentinel general practionners (GPs), completed in Guadeloupe between 1st June and 31st August 2016. Results : Regarding management of asthma exacerbations in primary care, 38,5% of pediatricians and 15% of GPs correctly prescribed short-acting ß2-agonist and 30,8% and 10% respectively prescribed them to continue at patients’ homes. Oral corticosteroid treatment was optimal at medical offices for 30,8% of pediatricians and 35% of GPs and respectively for 76,9%and 55%at patients’ homes. The prescription of controller medication with inhaled corticosteroids was appropriate for 69,2% and 50% respectively. Follow-ups were conducted by 76,9% of pediatricians and 85% of GPs ; 53,8% of pediatricians and 35% of GPs referred patients to pediatric pulmonologists, respectively 30,8% and 25% to an education center for asthma, and 15,4% and 50% to an allergy specialist. Standardised clinical guidelines (e.g monitoring record and written action plans) were achieved by 69,2% and 95%, and 61,5% and 75% respectively. Conclusion : Our study shows the necessity to standardise practices in order to improve asthma management and to strengthen the link between primary care and hospital.
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Master Thesis
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Submitted on : Thursday, October 26, 2017 - 9:22:32 PM
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Charline Bonnier. État des lieux de la prise en charge ambulatoire de l'asthme de l'enfant en Guadeloupe. Médecine humaine et pathologie. 2017. ⟨dumas-01624953⟩



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