Parents Often Mismanage Asthma Triggers

Despite Best Efforts, Parents Miss the Mark When Trying to Fight Triggers, Study Shows

From the WebMD Archives

Aug. 17, 2004 -- The best intentions go astray all too often when parents try to help their children overcome asthma.

That's the finding of University of Michigan researchers who collected data from a nationwide sample of 900 children aged 2 to 12 with asthma.

While most parents could identify an asthma trigger, more than half of the measures taken to control the asthma triggers didn't meet current guidelines and were likely to be ineffective, according to the study.

"These results suggest that parents spend a great deal of effort and significant resources on actions that are neither recommended nor reasonable," write Michael Cabana, MD, MPH, MA, and colleagues of the University of Michigan's pediatrics department.

Phone interviews were done with the household member who usually oversaw the child's asthma care. Open-ended questions were asked about the child's asthma triggers and what the family had done in response.

Plenty of effort was being made.

More than 80% of parents reported specific environmental triggers, and most (81%) took at least one step to try to help. Cabana and his colleagues counted more than 1,700 measures which parents took to control the environment.

"Action categories included: adding or buying a specific item for the home, specific cleaning of the home or part of the home, and removing or reducing exposure to the trigger," write the researchers.

But 51% of those measures weren't likely to help, according to current guidelines set by the National Heart, Lung, and Blood Institute.

For instance, 224 people said they had bought an air filter, but only 157 had an asthma trigger that "reasonably could be addressed by purchasing an air filter," write the researchers.

Only 1% of the actions were potentially harmful, such as buying a humidifier for children with asthma triggered by dust mites, which thrive in humid conditions.

Not enough was being done to fight tobacco smoke, a major asthma trigger. Of the 216 kids who lived with a smoker, only 16 families (7%) reported any attempts to reduce or eliminate smoke exposure.

There was no pattern suggesting what kinds of families were more likely to take effective actions. Education, income, and race were recorded but didn't seem to make a difference.

All families facing asthma that have a potentially modifiable trigger need much more guidance, say the researchers. Cabana says that providers should not assume that certain parents will adhere or not adhere to recommendations about the environment surrounding a person with asthma.

"It is important for clinicians to help families prioritize their actions to distinguish between those that are likely and unlikely to be helpful for the children's asthma," they write in the Journal of Allergy and Clinical Immunology.

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SOURCES: Cabana, M. Journal of Allergy and Clinical Immunology; August 2004. News release, University of Michigan.
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