Many Children Not Receiving Adequate Asthma Therapy

Asthma is the most common chronic illness of childhood, and hospitalization rates for childhood asthma have increased despite improvements in therapy. Many children in the United States with moderate to severe asthma do not receive recommended maintenance medications and may suffer avoidable medical difficulties because of this, according to a study from the University of Rochester School of Medicine and Dentistry, the Children's Hospital at Strong, and Rochester General Hospital.

Researchers analyzed data from the National Health and Nutrition Examination Survey, which provided cross-sectional, parent-reported data for children 2 months to 16 years of age over the period of 1988 to 1994. The survey focused on children with moderate to severe asthma (defined as having any hospitalization for wheezing, two or more acute care visits for wheezing, or three or more episodes of wheezing in the past year) and considered the children adequately treated if they had taken a maintenance medication during the past month. Of the 1,025 children studied who were diagnosed with moderate to severe asthma, only 26% had taken a maintenance medication in the past month. Inadequate maintenance therapy was more likely when any of the following factors were present: having Medicaid insurance, living in a Spanish-speaking household, and having a child under 5 years. Children surveyed after 1991, when national guidelines for asthma management became available, were no more likely to have taken the medications than children surveyed before that year.

The researchers concluded that most children with moderate to severe asthma in this national sample did not receive appropriate treatment with maintenance medications. Children living in poverty, young children, and those living in Spanish-speaking households were at particularly high risk of inadequate therapy.

What This Means to You: If your child has asthma, talk with your child's doctor about the best course of management, including the possible use of maintenance medications to control symptoms in moderate to severe asthma.

Source: PEDIATRICS, January 2000