Improving asthma care in children: revealing needs and bottlenecks through in-depth interviews

<bold>Introduction:</bold> 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. <bold>Methods:</bold> 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. <bold>Results:</bold> 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. <bold>Discussion:</bold> 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.