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Parents underestimate kids' asthma symptoms
July 14, 2011 / 3:50 PM / in 6 years

Parents underestimate kids' asthma symptoms

NEW YORK (Reuters Health) - Parents of kids with asthma don’t always realize when their children’s treatment is inadequate, a new drugmaker-funded survey suggests.

While more than seven out of every 10 parents interviewed described their child’s asthma as “mild” or “intermittent,” the disease was adequately treated in only six in 10 kids.

Based on stricter guidelines, the number of kids whose symptoms were kept in check by drugs dropped to fewer than two in 10, according to the new results, published in the European Respiratory Journal.

“Parents are only aware of asthma when the child is more severely ill,” Dr. Gordon Bloomberg, who was not involved in the study, told Reuters Health.

“Physicians cannot just ask the parent ‘how is your child doing?’ The physician will get a global answer that doesn’t reflect the child’s quality of life,” said Bloomberg, of Washington University in St. Louis.

Poor treatment may influence asthmatic children’s quality of life, as well as that of their families.

In the survey, more than four in 10 parents reported missing work because of their child’s asthma, and similar numbers of parents regularly lost sleep for the same reason.

The research was funded by Nycomed, a Swiss company that makes asthma medications and also helped write the new report.

According to the American Lung Association, asthma control includes monitoring symptoms, planning ahead for potential emergencies, reducing triggers of asthma attacks such as smoking, and taking enough medications.

More than seven percent of adult Americans, and even more kids, have asthma, causing millions of visits to emergency rooms and doctors’ offices every year.

For the survey, researchers interviewed 1,284 families in Canada, Greece, Hungary, The Netherlands, South Africa, and the UK. They asked the parents about how bad their child’s asthma was, using a common 25-point questionnaire called the Childhood-Asthma Control Test (C-ACT).

Then they interviewed the children and compared their answers to those of their parents.

One in four children whose parents described their asthma as “mild” or “intermittent” had poorly controlled asthma, defined as a score of 19 or lower on the test.

Using stricter asthma control guidelines, the number of kids whose disease was poorly controlled increased, report Dr. William Carroll of Derbyshire Children’s Hospital in Derby, UK, and colleagues.

The study also found children tended to be better than their parents at determining how well their asthma was being treated.

According to Dr. Gregory Sawicki, an asthma expert who wasn’t involved in the study, parents need more education about their child’s airway problems.

Doctors should “take each opportunity at each visit to assess control, and understand what the parent’s perception is...if there is a disconnect, use it as an educational opportunity,” Sawicki, of Children’s Hospital Boston, told Reuters Health.

Both Sawicki and Bloomberg agreed that kids with asthma should see a physician more often, at least three times a year, to monitor their symptoms and ensure that they and their parents know how to keep symptoms under control.

Carroll and his colleagues also found kids whose parents worry about medication side effects are more likely to have poorly controlled asthma.

Side effects include thrush, a treatable fungus infection in the mouth, and uncommon but serious problems throughout the body.

According to a new report, this suggests parents need more education about asthma medications.

But one expert said more medication is not the be-all and end-all for children.

“The idea of total control...is not where we should be putting our energy,” Dr. Barbara Yawn from Olmstead Medical Center in Rochester, Minnesota, told Reuters Health in an email.

Instead of just giving children with stubborn breathing problems more medication, she said better communication is needed to determine how children’s lives are affected, and what it will take to prevent their symptoms.

SOURCE: bit.ly/n2EtzP European Respiratory Journal, online June 23, 2011.

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