The Pharmaceutical Journal
Vol 269 No 7218 p473
5 October 2002

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Adequate asthma control not achieved in half of children

Half of children suffering from asthma do not achieve satisfactory symptom control, results of a Swiss study suggest.

Dr Claudia Kuehni and Dr Urs Frey of the University Hospital of Bern conducted a study involving 572 children aged 4–16 years, to find out if the goals of national and international guidelines for asthma management were being achieved.

They found that only 51 per cent of the children had reached the treatment goals, while the remainder suffered regularly from disturbed sleep, restriction of daily activities and school absences due to asthma.

Younger children had more problems than older children. Of those aged 13–16 years 66 per cent had no or minimal symptoms. This proportion decreased to 56 per cent, 44 per cent and 38 per cent in those aged 10–12, 7–9 and 4–6 years, respectively.

The researchers comment that doctors seemed to be reluctant to step up treatment in young children. And although all children were followed up by doctors and received inhaled treatment, the dosages of drugs were often lower than was indicated by disease severity and new treatment options and preventive measures were not exhausted.

In addition, many parents tolerated a relatively high degree of asthma symptoms in their children and classified their asthma control as excellent. The researchers suggest that these low parental expectations together with concern about side effects might cause unnecessary suffering in children.

"Parents and children should therefore be included more actively in disease management, with the aim to discuss and harmonise treatment goals and expectations between families and physicians," they conclude (European Respiratory Journal 2002;20:880).