Control of childhood asthma often overestimated

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Children with asthma and their parents often overestimate the level of disease control and commonly restrict activities to control symptoms, according to the results of the 2004 Children and Asthma in America Survey, released here Saturday during the 61st annual meeting of the American Academy of Allergy Asthma and Immunology.

“The majority of kids with asthma actually have a significant burden of disease if you ask about the different aspects of the disease including activity limitations—not just day or night time symptoms or even just symptoms in the last 4 weeks,” Dr. Anne L. Fuhlbrigge, from Brigham and Women’s Hospital in Boston, who presented the data, told AMN Health.

To investigate asthma-related health among US children, Fuhlbrigge and her colleagues conducted a telephone survey of a national sample of asthmatic children between 4 and 18 years of age. Among 41,433 US households surveyed, 1,089 children with asthma were identified and 801 interviews were conducted with parents and children.

The survey yielded an overall population rate of 9.2 percent for currently diagnosed asthma in this age group, according to the team.

“Congruence between perceived control of asthma and reported symptoms was poor,” Fuhlbrigge and colleagues reported.

Forty-seven percent of children experienced daytime symptoms during the past 4 weeks, 34 percent were awakened at night by their symptoms, and 49 percent reported asthma symptoms during physical activity, yet 78 percent of parents reported that the child’s asthma was “completely” or “well controlled.”

Twenty-six percent of children used rescue medication daily; 16 percent used these medications for 2 or more days per week. Avoiding exertion (47 percent) and staying indoors (34 percent) were common approaches to gaining control of asthma symptoms. More than half of respondents (55 percent) believed that only the symptoms of asthma can be treated.

“It’s important to take a multidimensional approach to childhood asthma and not to rely too much on parent reports of asthma control,” Fuhlbrigge said.

“When you get a global picture of what’s going on with the child’s asthma, you’re going to find out that asthma is impacting his or her life a lot more than if you quickly just say, ‘How’s your asthma?’” she said.

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