Abstract
Background: Children with difficult asthma (DA) have persistent poor control despite escalating treatment and are referred to specialist asthma multi-disciplinary teams (MDT). Physiotherapists can identify alternative causes of asthma-like symptoms e.g. breathing pattern disorders. However, few children with DA have access to physiotherapy, and MDT members may be unsure who to refer.
Aims: To identify which variables from a paediatric DA assessment predict physiotherapy referral and identify the prevalence of dysfunctional breathing.
Methods: A secondary data analysis of variables from all out-patient DA assessments including clinical features, symptom control (Asthma Control Test [ACT/cACT]), prescribed medication, spirometry, and psychosocial questionnaires between Jan 2015-Dec 2017. A multivariant logistic regression model assessed predictors, generating odds ratios used to develop a prototype screening tool. Physiotherapy notes were reviewed to ascertain dysfunctional breathing prevalence.
Results: 134 children (6-16 years) were included, 80.6% (108/134) were referred to physiotherapy. 65.3% (64/98) had dysfunctional breathing as assessed by physiotherapy. Three variables predicted physiotherapy referral; each additional year in age [p=0.02] (OR: 1.30 95% CI 1.02-1.66), increasing number of hospitalisations in the past 12 months [p=0.037] (OR: 1.55; 1.03-2.36) and each point increase in ACT/cACT scores [p=0.02] (OR:0.82; 0.68-0.98).
Discussion: Dysfunctional breathing is under-recognised but common in children with DA and specialist physiotherapy assessments are important. Screening tools to identify children who will benefit from specialist physiotherapy intervention require development.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 409.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020