Het Rotterdam Astma Onderzoek

Daily symptoms and exacerbations in children with asthma have significant impact on the quality of life of both the children and the parents. More effective use of asthma medication is advocated, since over- and undertreatment is reported in primary care. Trials in adults suggest better asthma control for patients with a regular medical review compared to patients without a regular medical review. Therefore, protocolled care by the General Practitioner (GP) may lead to better asthma treatment in children. However, this protocolled care by the GP may be time-consuming and therefore less feasible. Protocolled care in general practice supplied by a practice nurse, and under supervision of the GP, may give similar (or even better) improvements in asthma care for children.

The aim of this study is to determine the effect of protocolled practice nurse-led asthma care for children in primary care on asthma control (compared to usual care). Therefore, the practice nurses will receive an additional training and they will be provided with a protocol based on two Dutch guidelines; the NHG guideline and the ‘Zorgstandaard’. This study will be a cluster-randomized open label trial. The inclusion period will be 12 months, with a 18 months follow up. In this study, the practice nurses will be the units of randomization and children with asthma will be the units of analysis. 180 children aged 6-12 from the Southwest region of the Netherlands will be included. Primary objective will be the overall treatment effect (0 to 18 months) measured by the Childhood Asthma Control Test (C-ACT).