Many children who have asthma are 'silently suffering at home'

Many children who have asthma aren't using helpful medications or speaking regularly with health care providers about their symptoms, according to a study from the University of Rochester's Children's Hospital at Strong. The findings will be presented at the Pediatric Academic Societies' annual conference in Baltimore April 28 through May 1.

"This study included a diverse group of children from the inner city, suburbs, and rural areas, which I think makes the findings all the more striking," says the study's lead author, Jill Halterman, M.D., a pediatrician from Children's Hospital at Strong in Rochester, N.Y.

"In order to manage a child's asthma well, parents need to regularly communicate with the child's health care provider," Halterman says. "If asthma symptoms are not promptly and accurately reported, an adequate treatment plan can't be established or implemented."

Even though great strides have been made in understanding asthma and improving medications, asthma remains the most common chronic illness of childhood. Halterman says many children aren't benefiting from these advancements and are instead "silently suffering at home."

In a study published in the January 2000 issue of the journal Pediatrics, Halterman found that 74 percent of U.S. children with significant asthma aren't receiving recommended medications. For the study presented in Baltimore, Halterman and her colleagues wanted to know how families with children who have asthma manage symptoms at home, and examine potential gaps in communication with health care providers.

The study involved 168 children ages 6 to19 from Upstate New York. Those who experienced three or more asthma-related medical visits during the previous year were eligible. Through regular phone interviews with families and by monitoring daily diaries, extensive information was collected about asthma symptoms, medication use, and contact with health care providers.

The results strongly suggest that many children aren't getting their maintenance medications, nor are they in contact with a healthcare provider on a regular basis. During the three-month study period, only 47 percent of children with moderate to severe asthma used a preventive anti-inflammatory medication. Further, Halterman says, "the proportion of children having contact with a health care provider during this period was 50 percent or less, even among the children experiencing almost daily symptoms.

"It's possible that families don't keep in regular touch with a health care provider because they are desensitized to asthma symptoms and may expect their children to have a certain amount of illness on an almost daily basis," Halterman says. "They may also be unaware of the effective medications that are available, or concerned about potential side effects. Or, perhaps they face financial or cultural barriers to obtaining care."

The study was funded by a grant from the National Institutes of Health.