000680 - The Fundamental Role of Education in Achieving Control in a Child with Severe Uncontrolled Asthma

The Spanish Asthma Guideline (GEMA 5.4) highlights that children with severe, uncontrolled asthma requiring short courses of oral glucocorticoids (OGCs) may benefit from the addition of long-acting beta-agonists (LABAs) to their high-dose inhaled glucocorticoid (IGC) regimen to achieve optimal symptom control. Additionally, the guideline emphasizes that asthma education is recommended across all therapeutic steps and is particularly critical in cases of greater severity, where it may play a decisive role in achieving asthma control, potentially avoiding the need to add a biological therapy.

We present the case of a 6-year-old boy with recurrent bronchospasm episodes requiring oral glucocorticoids (OGC) and multiple hospitalizations, along with a persistent cough between episodes. Initial treatment with budesonide 200 mcg every 12 hours failed to control symptoms. The dose was escalated to Seretide (fluticasone propionate/salmeterol) 25/125 mcg and later to 25/250 mcg every 12 hours. Both, the boy and his parents also participated in the Asthma Education Program at La Paz University Hospital, gaining practical knowledge and management skills. They were trained in proper inhaler technique and taught to recognize early signs of an asthma exacerbation. An individualized action plan was established to guide treatment adjustments and prevent crises.

This strategy effectively controlled symptoms, improved quality of life, and eliminated hospitalizations and emergency visits. The educational program empowered the patient's parents to adjust medications as needed, maintaining asthma control, keeping the patient free from exacerbations, and thereby eliminating the need for oral corticosteroids.

The program emphasizes the importance of proactive parental involvement and collaborative healthcare support for effective and long-term asthma management. A well-structured Asthma Education Program also plays a crucial role in achieving asthma control, improving lung function, reducing exacerbations, and decreasing the patient's need for corticosteroids.