PT  - JOURNAL ARTICLE
AU  - Carolina Constant
AU  - Manuel Magalhães
AU  - Maria Gabriela Andrade
AU  - Duarte Malveiro
AU  - Ines Azevedo
AU  - Eduarda Sousa
AU  - Rizério Salgado
AU  - Teresa Bandeira
AU  - Ricardo M. Fernandes
TI  - Perspectives of pediatricians and general practitioners on diagnosis and treatment of bronchiolitis
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P1237
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P1237.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P1237.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - We assessed pediatricians' (Peds) and general practitioners' (GPs) perspectives on managing acute bronchiolitis (AB) and its concordance with a recent national guideline (NG).The ABBA study was a Portuguese nationwide online survey with members of the Portuguese Society of Pediatrics and GPs' mailing lists. Domains included diagnostic tests, treatments and hospital referral criteria, based on two clinical scenarios of AB severity (mild/moderate).514 Peds and 165 GPs participated (59% specialists), 48% Peds and 44% GPs reported implementing the NG. Peds used diagnostic tests in <1% of mild and 26% of moderate AB. For hospitalized cases, 82% agreed with viral testing and 45% with chest x-ray. Frequent use (>50%) of ≥1 bronchodilator was referred by 43% in mild and 78% in moderate AB (89% used a drug trial); salbutamol was the top choice [via spacer (40%), nebulised (32%)]. In moderate AB, frequent use of corticosteroids, adrenaline or hypertonic saline was reported by 33%, 21% and 20% Peds, respectively. The most used SpO2 thresholds for initiating and discontinuing O2 were 92% and 94%, respectively. Preferences of Peds between IV fluids, NG feeding were split at half. GPs referred to hospital 10% of mild and 93% of moderate AB, and up to 60% frequently used a bronchodilator. At their workplace, 34% did not have pulse oximetry and only 30% had spacers. Overall, NG recommendations were followed by 36% (diagnosis) and 12% (treatment) Peds; concordance was higher in those who reported implementing the NG (p<0.001).Management of AB is heterogeneous and diverges from the NG, particularly regarding treatment. Tailored strategies are needed to implement the NG at different levels of care.