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Francine Monique Ducharme

Francine Monique Ducharme
CHU Sainte-Justine University of Montreal · Pediatrics

MD. M.Sc.

About

287
Publications
34,315
Reads
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14,012
Citations
Additional affiliations
September 2008 - present
CHU Sainte-Justine
Position
  • Professor (Full)
Description
  • Associate Director Clinical Research and Knowledge Transfer Research Centre, CHU Sainte-Justine
September 2008 - present
Université de Montréal
Position
  • Professor (Full)
September 2008 - present
Université de Montréal
Position
  • Professor (Full)

Publications

Publications (287)
Article
Rationale: Integration of guidelines for severe asthma (SA) management into electronic medical records (EMRs) may greatly enhance asthma care and outcomes. Objectives: We aimed: 1) to develop an algorithm to identify SA patients in primary care EMRs using pan-Canadian standardized data elements and decision support that prompts adherence with best...
Article
Full-text available
Introduction Clinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The Paediatric Asthma in Real Life (PeARL) Think Tank aspires to develop recommendations based on the best available evidence from studies in chil...
Article
Full-text available
Importance: Despite guidelines recommending administration of intravenous (IV) magnesium sulfate for refractory pediatric asthma, the number of asthma-related hospitalizations has remained stable, and IV magnesium therapy is independently associated with hospitalization. Objective: To examine the association between IV magnesium therapy administ...
Article
Introduction: Asthma guided self-management enhances patients' control of their condition under the guidance of the treating physician. The aim of the present study was to understand how physicians perceive, endorse, uptake, and support asthma guided self-management. Methods: We conducted a secondary supplementary analysis of data originally col...
Article
BACKGROUND: Although asthma education and medical follow-up improve asthma control in efficacy trials, implementation issues may affect real-life effectiveness. OBJECTIVES: To assess the real-life impact of asthma education and/or specialized asthma care (SAC), in children referred to the Asthma Education Center (AEC) following an emergency departm...
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Full-text available
In the community setting, assessing spirometry in school-aged children is often limited by the unavailability of respirology technicians at the point-of-care. We developed a new technique called the Rapid Expiratory Occlusion Method (REOM) which measures respiratory resistance during normal breathing, without specialized training. The aim was to ex...
Article
Introduction: Early disease morbidity has been associated with asthma persistence in wheezing preschoolers; however, whether asthma control trajectories shortly after diagnosis could influence remission is unknown. We examined the association between asthma control trajectories 2 years post-diagnosis in preschoolers and subsequent disease remissio...
Article
Importance While intravenous magnesium decreases hospitalizations in refractory pediatric acute asthma, it is variably used because of invasiveness and safety concerns. The benefit of nebulized magnesium to prevent hospitalization is unknown. Objective To evaluate the effectiveness of nebulized magnesium in children with acute asthma remaining in...
Article
Background: It is unclear whether asthma may affect susceptibility or severity of the Coronavirus Disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic. Objective: To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients. Methods: An...
Article
BACKGROUND: Repeated emergency department (ED) visits for acute asthma signal poor asthma control. OBJECTIVE: We examined the effectiveness of a multifaceted intervention initiated in the ED to promote asthma education, medical visits and regular self-monitoring and to reduce morbidity following an acute care visit for asthma in children. METHODS:...
Article
RATIONALE: There exists no validated index to assess pediatric asthma control in pharmacoepidemiologic studies. OBJECTIVE: The objective of this study was to develop and validate a pharmacoepidemiologic pediatric asthma control index (PPACI) based on dispensed medications and health care utilization. METHODS: Using a population-based birth cohort,...
Article
Background: Pediatric asthma remains a public health challenge with enormous impact worldwide. Objective: The aim of this study was to identify and prioritize unmet clinical needs in pediatric asthma, that could be used to guide future research and policy activities. Methods: We first identified unmet needs through an open-question survey adminis...
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Introduction Preschoolers have the highest rate of emergency visits and hospitalisations for asthma exacerbations of all age groups, with most triggered by upper respiratory tract infections (URTIs) and occurring in the fall or winter. Vitamin D insufficiency is highly prevalent in Canadian preschoolers with recurrent asthma exacerbations, particul...
Article
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BACKGROUND: In asthmatic children, respiratory pathogens are identified in 60–80% of asthma exacerbations, contributing to a significant burden of illness. The role of pathogens in the clinical evolution of exacerbations is unknown. OBJECTIVE: We systema- tically reviewed the association between the presence of pathogens and clinical outcomes in ch...
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Introduction Overweight children with asthma may display impaired response to inhaled corticosteroids (ICS), possibly due to non-eosinophilic inflammation or weight-related lung compression; these mechanisms may differentially affect response to ICS and leukotriene receptor antagonists (LTRAs). We assessed whether weight status modified the respons...
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Purpose: The purpose of this study was to better understand patients' perspective of asthma self-management by focusing on the sociocultural and medical context shaping patients' illness representations and individual decisions. Patients and methods: We conducted a secondary analysis of semi-structured interviews carried out as part of a multice...
Article
Objective: The pediatric obese-asthma phenotype is associated with poor control, perhaps because of medication nonadherence. This study aimed to assess whether weight status is associated with nonadherence in children prescribed new asthma maintenance therapies. Methods: A historical cohort was constructed from a clinical database linking individua...
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Given the high proportion of patients with asthma who remain uncontrolled despite controller treatment, there remains a need for the development of more effective treatment options with a proven safety and tolerability profile. Recently, asthma guidelines have evolved to incorporate new therapies, including long-acting muscarinic antagonists (LAMAs...
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Background New evidence supports the use of supplemental vitamin D in the prevention of exacerbation of asthma; however, the optimal posology to sufficiently raise serum levels while maximising adherence is unclear. The objective was to ascertain the efficacy of high-dose vitamin D3 in increasing serum vitamin D in preschoolers with asthma and prov...
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Background With several commercially available devices measuring respiratory impedance by oscillometry, the agreement between values obtained on different instruments or frequencies remains unclear. Our aim was to examine the agreement between resistance and reactance parameters on two oscillometry instruments using different waveforms. Methods We...
Article
Background Most international asthma guidelines recommend that children ≤5 years with asthma or recurrent wheezing be treated with daily low‐ moderate dose inhaled corticosteroids (ICS) as the preferred controller and leukotriene receptor antagonists (LTRA) as alternative therapy. There is no systematic review comparing the efficacy of ICS versus L...
Article
RATIONALE: The Canadian Thoracic Society established a pan-Canadian respiratory standards initiative for electronic health records (EHRs) (PRESTINE). OBJECTIVE: We aimed to identify and define respiratory data elements for EHRs for asthma, COPD and related pulmonary function elements that enable adherence with respiratory best practice guidelines....
Article
BACKGROUND: Although daily inhaled corticosteroids (ICS) are the cornerstone of therapy, treatment adherence remains suboptimal in children with asthma. OBJECTIVE: We aimed to identify modifiable factors during the medical visit that may lead children and parents to adhere to prescribed ICS. METHODS: We conducted a cross-sectional mixed-method stud...
Article
Methods: We performed a secondary analysis of the Determinants of Oral Corticosteroid Responsiveness in Wheezing Asthmatic Youth (DOORWAY) study, a prospective cohort study of children (aged 1-17 years) presenting to the emergency department with moderate or severe exacerbations. Nasopharyngeal specimens were analyzed by RT-PCR for 27 respiratory...
Article
OBJECTIVE: The objective of this systematic review was to explore the effectiveness of various systemic corticosteroid (SCS) regimens to mitigate relapse in children with asthma discharged from an acute care setting. DATA SOURCES: Medline, EMBASE, Global Health, International Pharmaceutical Abstracts, EMB ALL, CINAHL, SCOPUS, Proquest Dissertations...
Chapter
Wheeze in preschool children (5 years of age and younger) is common. The majority of severe episodes are triggered by viral colds. Unlike atopic asthma in adults and young people, the underlying pathology of this condition is poorly understood, and the label of "preschool wheeze" should therefore not be regarded as a diagnosis but a description of...
Article
Background: Current evidence regarding the relationship between childhood obesity, decreased response to inhaled corticosteroids (ICS), and poor asthma control is conflicting. Objectives: We assessed if obesity: i) is associated with time-to-first exacerbation among children with asthma initiating Step-3 maintenance therapies; ii) modifies the e...
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Full-text available
Asthma: ENCOURAGING DOCTORS TO PROVIDE WRITTEN ACTION PLANS: Changes to practice organization and doctors' perceptions should encourage the provision of written action plans for all asthma patients. International guidelines state that effective long-term treatment of asthma requires educated self-management, regular reviews and provision of a writ...
Article
RATIONALE: While severe asthma affects approximately 5% of all individuals with asthma, this small minority of individuals accounts for a large proportion of the asthma-related costs. Greater understanding of the pathophysiology of asthma combined with the emergence of novel biologic therapies for severe asthma supported the need for a thorough rev...
Article
Full-text available
Background In asthmatic children, 60–80% of exacerbations are triggered by respiratory pathogens and represent an important burden of illness. The impact of pathogens on exacerbation severity and treatment response remains unclear. Our aim was to describe the prevalence of respiratory pathogens in children presenting to the emergency department (ED...
Article
Although montelukast is generally well tolerated, postmarketing studies have reported serious neuropsychiatric adverse drug reactions (ADRs) leading to a United States Food and Drug Administration black box warning. The objective of this study was to determine the incidence of neuropsychiatric ADRs leading to discontinuation of montelukast in asthm...
Article
Background: Asthma management guidelines recommend low-dose inhaled corticosteroids (ICS) as first-line therapy for adults and adolescents with persistent asthma. The addition of anti-leukotriene agents to ICS offers a therapeutic option in cases of suboptimal control with daily ICS. Objectives: To assess the efficacy and safety of anti-leukotri...
Article
Objectives: While systemic corticosteroids (SCS) are widely used to prevent relapse in adults with acute asthma discharged from the emergency department, the most effective route of administration is unclear. The objective of this review was to examine the effectiveness of SCS in adults and to identify the most effective route of SCS to preventing...
Article
Full-text available
PurposeThere are very few studies on primary adherence (i.e., first filling of a prescription) to inhaled corticosteroids (ICS) in asthma patients; two have involved children. Moreover, adherence can be overestimated when considering only secondary adherence (i.e., following the medication recommendations for a defined period) and ignoring primary...
Article
Results: Seven meta-analyses and 14 RCTs were reviewed. Daily ICS should be the preferred drug for infants/preschoolers with recurrent wheezing, especially in asthmatics. For those with moderate or severe episodes of EVW, the use of high intermittent ICS doses significantly reduce the use of OCS. There is no evidence of effect of intermittent ICS...
Article
Background: Asthma control remains suboptimal in Canada. Expansion of pharmacist's professional activities offers the opportunity to improve the interdisciplinary management of patients with asthma. Objective: The aim of this study was to determine the level of agreement of physicians regarding the expansion of pharmacists' professional activiti...
Article
Full-text available
Background: Trials in school-aged children suggest vitamin D supplementation reduces asthma exacerbations. Primary aim: to examine whether vitamin D3 (100,000 IU) rapidly raises serum 25-hydroxyvitamin D (25OHD) ≥75 nmol/L in asthmatic preschoolers. Methods: In a double-blind, randomised, placebo-controlled trial, preschool-aged children with as...
Article
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This article provides data and a method related to a research paper entitled “Assessing vitamin D nutritional status: Is capillary blood adequate?” [1]. Circulating 25OHD, the accepted biomarker of the vitamin D nutritional status, is routinely measured by automated immunoassays, that although may be performed in hospital central laboratories, ofte...
Article
Background: The management of paediatric asthma exacerbations is based on trials in children of all ages. Recent studies from 2009 raised the possibility that preschoolers (younger than 6 years) with viral-induced wheezing and children exposed to tobacco smoke might be at an increased risk of treatment failure. The study objective was to identify...
Chapter
Background: People with asthma may experience exacerbations or "attacks" during which their symptoms worsen and additional treatment is required. Written action plans may advocate doubling the dose of inhaled steroids in the early stages of an asthma exacerbation to reduce the severity of the attack and to prevent the need for oral steroids or hos...
Article
International guidelines recommend adding long-acting β2-agonists (LABA) to inhaled corticosteroids (ICS) as a step 3 or 4 strategy in children in whom ICS, with or without adjunct therapy, is ineffective in adequately controlling asthma [1–4]. Contrary to adults, the beneficial effects of ICS/LABA in children are limited to improving lung function...
Article
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Background Up to 30 % of children with acute asthma are refractory to initial therapy, and 84 % of this subpopulation needs hospitalization. Finding safe, noninvasive, and effective strategies to treat this high-risk group would substantially decrease hospitalizations, healthcare costs, and the psycho-social burden of the disease. Whereas intraveno...
Article
Full-text available
Objective . We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods . We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical vignettes of a poorly controlled adult or child...
Data
The supplemental materiel describes the clinical vignettes (Table E1), the comparison between participants and non-participants (Table E2), the reported assessment of, and prescription for, each case vignette (Table E3), the beliefs about capabilities and consequences regarding the prescription of long-term asthma controller (Table E4), the multiva...
Article
Full-text available
Background: Long-acting beta2-agonists (LABA) in combination with inhaled corticosteroids (ICS) are increasingly prescribed for children with asthma. Objectives: To assess the safety and efficacy of adding a LABA to an ICS in children and adolescents with asthma. To determine whether the benefit of LABA was influenced by baseline severity of air...
Article
Abstract BACKGROUND: Episodic viral wheeze (EVW) associated with viral respiratory tract infections is a common reason for pre-school children to utilise health care resources and for carers to take time away from employment. About a third of children experience a wheezing episode before the age of five years. EVW therefore represents a significant...