Many Parents Underestimate Kids' Asthma Symptoms

From Reuters Health Information

By Eric Schultz
NEW YORK (Reuters Health) Jul 13 - 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 70% of parents interviewed described their child's asthma as "mild" or "intermittent," the disease was adequately treated in only 60% of the kids.
Based on stricter guidelines, the proportion of kids with well controlled symptoms dropped below 20%, according to the new results, published June 23rd 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 Dr. Bloomberg, of Washington University in St. Louis.
In the survey, more than 40% of parents reported missing work because of their child's asthma, and a similar proportion 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.
For the survey, researchers interviewed 1,284 families in Canada, Greece, Hungary, The Netherlands, South Africa, and the UK 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," Dr. Sawicki, of Children's Hospital Boston, told Reuters Health.
Both Dr. Sawicki and Dr. Bloomberg agreed that kids with asthma should see a physician at least three times a year, to monitor their symptoms and ensure that they and their parents know how to keep symptoms under control.
Dr. Carroll and his colleagues also found kids whose parents worry about medication side effects are more likely to have poorly controlled asthma. They say 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: http://bit.ly/n2EtzP
Eur Resp J 2011.