Assignment Question
When managing patients in general practice, it is important that we practise based on the best clinical evidence. We need to keep abreast of the latest information by searching for information systematically on reliable internet resources, attending conferences and reading journals. Textbooks, though good for acquiring basic principles and facts, are often not up-to-date.
This assignment aims to guide you to look for the latest clinical evidence on an evidence-based database (Cochrane Library). It focuses on the latest treatments for managing acute problems in children.
Task:
Please answer the following clinical questions by searching for evidence at the Cochrane Library.
Scenario
A 7-year old girl has a history of bronchial asthma since 3 years old. She presents to your clinic with acute exacerbation of asthma with breathlessness, wheezing and cough for the past 1 day. You have given her nebuliser salbutamol, and there is an improvement in her symptoms.
Questions:
Would you prescribe a course of oral steroid to this child?
Write down your answer according to your usual practice (before searching for the evidence)
Now, visit the Cochrane Library by clicking on the following link to search for the evidence: https://www.cochranelibrary.com .Search for the relevant Cochrane Review using the appropriate keywords: ‘asthma, ‘child’ and ‘steroid’. Look for the review ‘ Corticosteroids for preventing relapse following acute exacerbations of asthma’ by Rowe BH, Spooner C, Ducharme F, Bretzlaff J, Bota G (2008)
Read the summary of the Cochrane Review and answer the question as follows:
1. What kind of research study design is a Cochrane Review?
2. Does steroid during an acute exacerbation of asthma reduce additional care or hospitalisation? If so, how long is the drug effect maintained?
3. Which group has more side effects? The treatment group or control group? State the reason.
4. How many children need to be treated with a steroid to prevent future relapse after an acute asthma exacerbation?
5. Would you prescribe a course of steroid to this girl? How long would you prescribe? Explain.
