Pediatric Bronchiectasis Action Management Plan to Improve Clinical Outcomes: A Randomized Controlled Trial.

However, evidence-based strategies among the pediatric population remain limited.

然而，在儿童人群中，基于证据的策略仍然有限。

research_question

Does the use of a personalized, written bronchiectasis action management plan (BAMP), compared with standard care, reduce nonscheduled physician visits among children and adolescents with chronic suppurative lung disease (CSLD)/bronchiectasis?

使用个性化的书面支气管扩张症行动计划（BAMP），与标准护理相比，是否能减少慢性化脓性肺病（CSLD）/支气管扩张症儿童和青少年的非计划性医生就诊次数？

study_design_and_methods

This multicenter, double-anonymized, superiority, randomized controlled trialenrolled children from 3 Australian respiratory departments between June 2018 and December 2020.

这项多中心、双匿名、优效性、随机对照试验于2018年6月至2020年12月期间在澳大利亚的3个呼吸科部门招募儿童。

Children and adolescents aged < 19 years with CSLD/bronchiectasis were randomized to receive a personalized BAMP (intervention) or standard care (control participants).

年龄小于19岁的患有CSLD/支气管扩张症的儿童和青少年被随机分配接受个性化BAMP（干预组）或标准护理（对照组）。

The primary outcome was the annual rate of acute nonscheduled physician visits for respiratory exacerbations, after randomization.

主要结果是在随机分配后，因呼吸道加重而进行的非计划性急性医生访问的年率。

Secondary outcomes were the annualized rate of acute exacerbations, scores on the 8-item Parent Cough-specific Quality of Life questionnaire, and proportion receiving timely annual influenza vaccination.

次要结果包括急性加重的年化发生率、8项家长咳嗽特异性生活质量问卷评分以及及时接种年度流感疫苗的比例。

Results

Of the 207 children enrolled, 194 were included in the known-case intention-to-treatanalysis (BAMP group, n = 99; control group, n = 95).

在纳入的207名儿童中，有194名被纳入已知病例意向治疗分析（BAMP组，n=99；对照组，n=95）。

There was no significant difference in the annualized rates of nonscheduled respiratory-related physician visits (median [interquartile range]: BAMP, 2 [0-4]; control, 2 [0-4)]; incident rate ratio, 0.98 [95% CI, 0.71-1.36]).

在非计划的呼吸系统相关医生就诊的年化率上没有显著差异（中位数[四分位数间距]：BAMP组，2 [0-4]；对照组，2 [0-4]；发生率比，0.98 [95% 置信区间，0.71-1.36]）。

However, in the sensitivity analysis limited to pre-COVID-19 data (BAMP group, n = 42; control group, n = 44), there was a reduction in nonscheduled respiratory-related physician-related visits in the BAMP group (incident rate ratio, 0.63; 95% CI, 0.38-1.04; P = .07).

然而，在仅限于COVID-19疫情前数据的敏感性分析中（BAMP组，n = 42；对照组，n = 44），BAMP组的非计划呼吸系统相关医生就诊有所减少（发生率比，0.63；95% 置信区间，0.38-1.04；P = .07）。

In the intention-to-treatanalysis, patients in the BAMP group were significantly more likely than control partcipants to receive timely annual influenza vaccination (74 of 103 vs 58 of 102, respectively; OR, 2.03; 95% CI, 1.13-3.65; P = .017).

在意向治疗分析中，与对照组参与者相比，BAMP组患者更有可能及时接受年度流感疫苗接种（分别为103人中的74人和102人中的58人；比值比，2.03；95%置信区间，1.13-3.65；P = .017）。

interpretation

Among children and adolescents with CSLD/bronchiectasis, using a BAMP was shown to improve timely influenza vaccination uptake but did not significantly reduce nonscheduled physician visits.

在患有CSLD/支气管扩张症的儿童和青少年中，使用BAMP被证明可以提高及时接种流感疫苗的比率，但并未显著减少非计划的医生就诊次数。

However, the results were likely influenced by the COVID-19 pandemic, and data prior to the COVID-19 pandemic show a clear trend toward efficacy of the BAMP, with a 37% reduction in unscheduled physician visits.

然而，这些结果很可能是受到了 COVID-19 大流行的影晌，而大流行前的数据显示 BAMP 的有效性有明显趋势，未计划的医生就诊减少了 37%。

In addition, consumer feedback was strongly positive regarding the BAMP's usefulness and practicality.

此外，消费者反馈对 BAMP 的实用性和有效性给予了高度肯定。

clinical_trial_registration

Australian and New Zealand Clinical Trials Register; No. ACTRN12618000604202; URL: www.anzctr.org.au.

澳大利亚和新西兰临床试验注册处; 注册号 ACTRN12618000604202; 网址: www.anzctr.org.au.