Application Of China Children Asthma Action Plan In Outpatient Management Of Asthmatic Children Aged 5 Years Or Younger

Objective: In the era of "Internet +",using the mobile phone as a carrier and the Internet as the medium,the Asthma Action Plan was implemented in asthmatic children under 5 years old to track asthma control and treatment compliance,explore the role of Internet technology in the chronic disease management,and evaluate the value of the Asthma Action Plan for outpatient management of asthmatic children under 5 years old.Methods: 105 children under 5 years old were admitted to the pediatric outpatient clinic in the Affiliated Hospital of Qingdao University.All parents were required to join the Asthma Action Plan platform through their mobile phones.The Asthma Action Plan was divided into three zones of “red,yellow and green” depending on the symptoms.The doctor instructed parents to judge the condition according to the symptoms,use drugs in line with the action plan of the corresponding area.Parents needed to record the symptoms and medications of their child on the mobile phone platform every day.The Test for Respiratory and Asthma Control in Kids(TRACK)was used to assess asthma control,outpatient department visits were required once a month.All client terminal data was automatically transferred to the doctor's platform terminal.The total follow-up time was 3 months.Data were collected and statistically analysed by SPSS 24.0 software.A P-value <0.05 was considered to be statistically significance.Results:1.General conditions: A total of 105 asthmatic children,including 75 boys and 30 girls were included.The median age was 32.4 months.The average weight is 15.8kg and the average height is 94.4cm.2.Condition of acute asthma attack: The number of acute asthma attacks,emergency room visits,bronchodilators using,and systemic corticosteroids using were reduced after using Asthma Action Plan,and there was statistical significance(P<0.05).3.Condition of asthma control: The TRACK scores at the time of enrollment,the first month of intervention,the second month of intervention,and the third month of intervention were 62.50(50.00,80.00)?85.00(70.00,95.00)?87.50(78.75,95.00)?92.50(80.00,100.00),the difference was statistically significant(F =115.383,P<0.05).The proportion of children who achieved asthma control(TRACK score?80)at the first month,the second month,and the third month of intervention were 62.8%,76.7%,and 79.1%,and the difference was statistically significant(x~2 = 6.7441,P<0.05).4.Symptom changes: The proportion of children with daytime symptoms at the first month,the second month,and the third month of intervention were 93.1%,57.5%,and 42.5%,the difference was statistically significant(x~2 = 51.2177,P<0.05).The proportion of children with nocturnal symptoms at the first month,the second month,and the third month of follow-up were 70.1%,46.0%,and 28.7%,respectively.The nocturnal symptoms of the children were gradually improved(x~2=30.1048,P<0.05).5.Medication compliance: The implementation rates of medication at the first month,the second month,and the third month of intervention were 80.2%,74.8%,and 68.0%,respectively;the mean medication implementation rate during intervention time was 74.3%.6.Outpatient revisit: The outpatient revisit rate at the first month,the second month,and the third month of intervention were 92.0%,83.9%,and 62.5%,respectively.There was 79.5% of children who completed three outpatient revisits during the whole intervention time.Conclusions:1.In the "Internet +" era,the combination of new Internet technology and traditional medicine provides a new platform for the long-term management of low-age children with asthma.2.The Asthma Action Plan intervention can reduce asthma acute attacks,alleviate symptoms,achieve asthma control,improve treatment adherence and clinical outcomes,and promote individualized management of asthmatic children aged 5 years or younger.