March 15, 2007 -- Four out of five kids with asthma don't keep their symptoms under control, a new study shows.
University of Rochester researcher Jill S. Halterman, MD, MPH, and colleagues analyzed data from a telephone survey of 975 asthmatic children in Alabama, California, Illinois, and Texas.
Among children with persistent asthma, they found:
- An additional 43% of these kids have asthma drugs but still aren't controlling their asthma.
- Only 20% of kids with persistent asthma keep their symptoms under control.
"We found inadequate treatment is still a problem. We found a large number of kids had persistent asthma symptoms but no medications," Halterman says.
An even larger number of kids had their lives interrupted by persistent asthma symptoms despite having inhalers. There were several reasons for this.
One major reason is that these children weren't using their inhalers every day. The drugs work properly only when used consistently.
"And a significant number of these kids were exposed to triggers -- including secondhand smoke -- which clearly makes asthma worse even if medications are being used," says Halterman.
The study appears in the March issue of Ambulatory Pediatrics.
Parents Who Smoke -- and Other Asthma Triggers for Kids
Smoking? Around kids with asthma? Yes. More than 15% of the kids' parents admitted to smoking around their children in the past week.
"That's obviously an underestimate, as many parents would not admit this," Halterman says. "But that's still a striking percentage."
Indeed, more than a third of children under age 18 live with at least one smoker, according to new statistics released by the U.S. Agency for Healthcare Research and Quality.
Children with asthma are just as likely to live with a smoker as other kids are, the AHRQ finds.
The list includes:
- A fireplace or wood stove
- A kerosene heater
- An unvented gas stove
- Cockroach infestation
- Dust mites
- Visible mold
- Indoor pets
Pets and Asthma
Does this mean Fluffy and Fido must find a new home?
"That is a tough question," Halterman admits. "Some children are clearly allergic to pets. They would benefit. But others might not, so it takes treatment planning with your doctor."
Pediatric allergist Lisa Kobrynski, MD, MPH, assistant professor of pediatrics at Atlanta's Emory University, agrees that the pet discussion is always a hard one for families of children with asthma.
One solution, she suggests, is keeping the pets outside. Some families try frequent washing, but Kobrynski notes that this means washing a dog or cat at least three times a week. And new research suggests that some pet allergens aren't from pet dander, but from pet saliva.
Asthma Control Key: Frequent Evaluation
Controlling a child's asthma, Halterman and Kobrynski stress, is not a simple matter. It requires collaboration between parents, the child, and the child's doctors.
The first step is reporting the child's symptoms to a doctor. The doctor then develops an individualized asthma-control plan, which often includes daily use of an inhaler and may require oral medications, too. Daily use of these drugs is essential. But taking medicine isn't the end of the job.
Avoiding asthma triggers is an essential component of asthma control. And asthma triggers are tricky -- new ones can pop up, and old ones may or may not go away.
"Asthma is not a static disease -- it changes over time," Kobrynski says. "Kids may develop new triggers, and their asthma may change -- it may become more severe. At least two or three times a year, they need re-evaluation to see if their treatment plan is adequate."