Many Asthmatic Children Have Poor Control Over Symptoms

Many children with asthma have poor control over their symptoms due to either a lack of preventive treatment or ineffective treatment, according to preliminary research from the University of Rochester Medical Center.

Only 20 percent of the children with persistent asthma in the 2003 State and Local Area Integrated Telephone Survey, which relied on parent-reported data from Alabama, California, Illinois and Texas, had intermittent symptoms with one or fewer doctor visits due to asthma symptoms. Thirty-seven percent of the children had inadequate therapy, which was classified as having persistent symptoms in the past month with no report of preventive medication use. Black children, Hispanic children and children with discontinuous insurance status were at highest risk for receiving inadequate therapy with preventive medications.

"We still have a lot of work to do to assure that children with significant asthma use effective preventive therapy, and we must work with families to ensure that children have consistent health insurance coverage and continuity of care," said lead researcher Jill Halterman, M.D., M.P.H., assistant professor at the university's Golisano Children's Hospital at Strong.

In addition, almost 43 percent of the children had persistent symptoms or more than one acute doctor's visit in the past three months despite preventive medication use. Potential explanations for poor symptom control included improper use of medications (35 percent), recent exposure to smoke (10.7 percent), exposure to other household triggers (69.6 percent) and lack of a written asthma management plan (52.7 percent).

Halterman said the research highlights the concern that a substantial number of children are not using effective preventive medications, or experience poor symptom control despite use of preventive medications. She added that further studies are needed to test both patient-focused and physician-focused strategies to optimize asthma care for these children.

The research was funded by The Halcyon Hill Foundation, and the Robert Wood Johnson Foundation's Generalist Physician Faculty Scholars Program.

The Pediatric Academic Societies (PAS) Annual Meeting is the largest international meeting that focuses on research in child health. The PAS consists of the American Academy of Pediatrics, Ambulatory Pediatric Association, American Pediatric Society, and Society for Pediatric Research.