Treatment adhesion: rethinking the care pathway of asthmatic patients in Belgium

Introduction: One of the main recommendations to improve chronic asthmatic patients' adhesion to their treatment is the implementation of a coordinated care pathway aiming at facilitating disease management by the patient while meeting his needs and expectations. Purpose of research: To study through a critical literature review and a short survey how this care pathway can be set up and adapted to the Belgian context. Results: A model including the three healthcare levels in Belgium was developed. The first level is mainly formed by general practitioners while the second and third are centralized around a structure called asthma clinic. This latter would provide a full asthma assessment, its chronic follow-up and treatment for severe asthma. Roles of healthcare professionals working with the asthmatic patient were identified and described. This model is discussed in the light of the present Belgian situation according to different plans: asthma management, effective interdisciplinary communication, advanced nurse practitioner's role implementation. Conclusion: Although the Belgian context is currently not suitable enough for allowing this new nursing function to arise, our model lays the foundations of a system which is adapted to complexity of Belgium, follows from validated experiences on international scene, and offers an answer to chronic asthmatic patient's needs and expectations.