Introduction

Asthma affects 7% of Dutch children and poses an increasing challenge, highlighting the need for effective pediatric care. Achieving optimal asthma control is crucial given the potentially negative long-term effects on lung development in young children. The aim was to understand the challenges and requirements of current asthma care in children.

Methods

In a qualitative explorative study, semi-structured, in-depth interviews were held among 37 stakeholders. A total of 15 patients and their parents, 10 general practitioners (GP?s), 5 pediatricians/pediatric pulmonologists and 7 nurse practitioners participated. Analysis was based on a thematic inductive analysis, using open and axial coding.

Results

GP?s tend to emphasize treating children with acute symptoms, underestimating chronic disease management, leading to possible over- and undertreatment. Fragmented care between primary and secondary healthcare worsens these challenges. Moreover, the absence of well-established follow-up structures in primary care contributes to insufficient self-management skills among patients. Shared Decision Making (SDM) lacks a tailored approach, with variable engagement levels among healthcare providers. Limited focus on preventive strategies, such as advocating healthy lifestyles, lead to limited attention to alternative treatments. 

Discussion

The study provides valuable insights to improve the quality and continuity of care for children with asthma and their parents. It underlines the need for a comprehensive and transmural care pathway, and in order to minimize the long-term negative effects of uncontrolled asthma.