Improving Care for Children with Asthma: Shared Decision-Making Project

The aim of this project is better, appropriate care, in which children are better involved in the treatment

Between 5 and 10% of children have asthma, but care for these children is not optimally organized. The MosaKids Children’s Hospital (Maastricht UMC+), Zuyderland Medical Center and Limburg general practitioner organizations have therefore received a subsidy from the Healthcare Institute of more than €994,000 for the project ‘Shared decision-making in children with asthma’. The aim of this project is better, appropriate care, where children are better involved in the treatment and there is seamless cooperation between the GP and the hospital.

Asthma is a chronic inflammation of the airways, causing complaints such as shortness of breath, coughing and wheezing. Patients are often less able to exert themselves than their peers, sleep poorly, tire quickly and cannot always participate with their peers. Because asthma has a major impact on the child and family, it is extremely important to find a treatment that suits the child and his or her environment.

Listen
In the project we are developing a decision aid and a special patient questionnaire that help healthcare providers and children and their parents in Shared Decision Making. Edward Doppeling, pediatric pulmonologist at MosaKids Children’s Hospital: ‘Knowing what children find important, what goals they have and involving them in decisions about their health are fundamental elements of person-centered care. If children are central, this leads to more involvement in their health and in the long term they can take better control. That’s what we call Shared Decision Making.’

However, that does not always work. ‘That is why we are going to develop a decision aid that helps children and their parents make a joint choice regarding medication and a healthy lifestyle.’ Moreover, more is often possible than parents and children think, Dompeling explains. ‘If we know better what is important to the child, we can provide tailor-made solutions. We also pay attention to factors that also influence the child’s health, such as exercise and nutrition.

Monitoring
Because asthma is a chronic condition with a variable course and many healthcare providers are involved: general practitioners, pediatricians (pulmonologists), nurses, cooperation between 1st, 2nd and 3rd lines is important. However, we still see a lot of room for improvement here. Marieke van Horck, pediatric pulmonologist Zuyderland MC: ‘Because healthcare professionals do not always coordinate optimally or do not know where to find each other, a child with asthma may not receive the optimal treatment.’ Better cooperation is stimulated by developing a care path. It is also examined whether digital monitoring is valuable to gain a good picture of the child and his or her environment. In addition, the monitoring must be a place where patients, their parents and all healthcare providers can always follow the latest developments and where accessible contact is possible. We want to keep healthcare providers as informed as possible about how their patients are doing. This way, all healthcare professionals can better coordinate and make decisions about treatment.

Regional approach
The collaboration in the South Limburg region is unique. MosaKids Hospital, Zuyderland Medical Center and general practitioner organizations HOZL and MCC Omness work intensively together to arrange regional care for children with asthma. Intensive collaboration and innovation are necessary to manage the demand for care properly. The organizations are taking steps to jointly arrive at a care path (agreements about what good care is and where it is provided), a relevant questionnaire and a decision aid. The new approach will be visible in some practices from April 2024.

The project was made possible in part by the Dutch Healthcare Institute with a subsidy from the subsidy scheme ‘Learning to use Outcome Information for Shared Decision Making’. The Healthcare Institute implements this scheme on behalf of the Ministry of Health, Welfare and Sport.

Bron: Maastricht UMC+

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2023-11-20 07:00:21
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