PRM is a busy subspecialty that is important to the work of many other clinical groups. Across Europe, there remain obvious disparities in the number of PRM experts and in the levels of morbidity and mortality from childhood respiratory conditions; these disparities should be addressed. Looking ahead, in the coming years, the PRM community aims to continue to work with patient groups and funders to deliver clinical trials upon which to base best practice of care and in order to lobby for improvements in air quality. As with all things, this will require time, money, and most of all, leadership.

Future recommendations

  • Greater recognition of PRM as a subspecialty across Europe. There should be PRM specialists in every country as well as training in PRM.

  • Narrowing of the gap between the highest and lowest national burden of respiratory morbidity and mortality across Europe, including standardisation of diagnosis and treatment.

  • Acknowledgement of the need for researchers to design and funders to support clinical trials in PRM for pharmacological and nonpharmacological interventions.

  • Greater recognition of the effect of early exposure on lifelong respiratory wellbeing, including improvement of indoor and outdoor air quality and prevention of smoking in children in Europe (and the rest of the world).

See the entire Paediatric respiratory medicine Chapter