About 5.8 million children in the United States have been diagnosed with asthma - it's one of the most common chronic illnesses among children. For some kids with asthma, missed school, activity restrictions, emotional distress, and hospitalizations and emergency medical treatment are a way of life. Although government health agencies like the National Heart, Lung, and Blood Institute have set goals for treating asthma in children, they're not often met, say researchers who conducted the Children and Asthma in America survey, sponsored by the pharmaceutical company GlaxoSmithKline.
In the survey, 801 parents of children with asthma (and 284 of the children) answered questions about asthma during a 47-minute interview. Here are some of the major findings:
- Many children experienced asthma symptoms. In the previous 4 weeks, 67% of children experienced daytime or nighttime asthma symptoms or symptoms brought on by exercise. About one in five children experienced daytime symptoms of asthma three times a week or more, and about one quarter experienced symptoms at night once a week or more.
- Emergency visits for asthma were common. One quarter of the survey respondents had visited the emergency room for asthma within the last year, and 42% said they'd had an unscheduled visit with a doctor because of asthma symptoms or attacks.
- Kids missed school and parents missed work because of asthma. More than half of the children in the survey missed school or child care in the previous year because of asthma. On average, children missed 4 days of school or child care. More than one third of parents missed work in the last year because of their child's asthma.
- Rescue inhalers are used frequently. Forty-two percent of children who had used a quick-relief medication for asthma in the past 4 weeks reported using it three times a week or more.
- Kids often lack a written plan for treating asthma. Half of the children with asthma surveyed did not have a written asthma action plan.
- Many children with asthma aren't regularly monitored by a doctor or health care provider. One quarter of children with asthma hadn't seen a doctor for asthma during the previous year; half of all children with asthma had not had a lung function test in the prior 12 months.
All of the findings described above fell short of the NHLBI's national treatment goals for children with asthma, even though four out of five parents surveyed said their child's asthma was well or completely controlled. Researchers also discovered that there's a disconnect between how parents perceive their children's asthma and how the children perceive the disease. Frequently, kids with asthma disagreed with their parents about symptoms and how symptoms affect their daily life. Almost three quarters of parents and their children disagreed about the child's overall health status.
Parents may also be lacking crucial information they need to understand their child's asthma management and treatment. Ninety percent of parents hadn't heard about the symptom bronchoconstriction (tightening of muscles in the airways), and 93% of parents didn't know that inflammation (swelling and irritation) of the airways was a major cause of asthma symptoms.
Finally, many children with moderate or severe asthma weren't taking medications to help them control asthma on a long-term basis. About half of children with severe asthma and only two thirds of those with moderate asthma had taken prescription medications (like an inhaled corticosteroid) in the last 4 weeks, even though national guidelines say that inhaled corticosteroids are the best way to treat persistent asthma.
What This Means to You: These study findings make it clear that many children aren't getting the asthma treatment and management they need. But the good news is that for most children, asthma can be well controlled and the incidence of asthma flare-ups and symptoms can be reduced. There are several steps to help your child manage his or her asthma:
- identify and control asthma triggers
- anticipate and prevent asthma flares
- take medications as prescribed
- control flare-ups by following the doctor's written, step-by-step plan
- learn more about asthma, new medications, and treatments
Work with your child's doctors to take these steps toward more effective management of your child's asthma.
Source: Children and Asthma in America Survey (www.asthmainamerica.com), Asthma Action America, December 2004
Reviewed by: Steven Dowshen, MD
Date reviewed: January 2005
