Few Kids Achieve Asthma Control, Despite Tx

SAN FRANCISCO — A study of 975 asthmatic children in four states found only one child in five achieved optimal symptom control through use of preventive medication.

While 37% of the symptomatic children did not use any preventive medications, 43% had persistent symptoms despite parent reports that these children used their prescribed therapies, according to data Dr. Jill S. Halterman presented at the annual meeting of the Pediatric Academic Societies.

“We still have a lot of work to do to identify children with persistent asthma, and to ensure that they use effective preventive therapy,” said Dr. Halterman of the University of Rochester (N.Y.) and its Golisano Children's Hospital at Strong, also in Rochester.

She called the substantial number of children with poor asthma symptom control despite reported use of preventive medications “a newly highlighted concern.”

Dr. Halterman and her coinvestigators based their findings on parent responses to the Asthma Survey Form included in the 2003 State and Local Area Integrated Telephone Survey (SLAITS), a random-digit-dial survey. The sample covered Alabama, California, Illinois, and Texas.

For the analysis, the researchers selected parents of children aged 17 years and younger who had persistent symptoms according to national asthma guidelines and/or used preventive asthma medications (defined as inhaled corticosteroids, mast cell stabilizers, theophylline derivatives, leukotriene modifiers, and combined corticosteroids and long-acting β₂-agonists).

Poor children were at the highest risk of receiving inadequate therapy, according to Dr. Halterman's poster and a talk she gave at the meeting, which was sponsored by the American Pediatric Society, Society for Pediatric Research, Ambulatory Pediatric Association, and American Academy of Pediatrics.

More than half (53%) of children from families with incomes less than $15,000 a year did not use any medication and had persistent symptoms during the month before their parents were surveyed. Another 35% of poor children had suboptimal control, which the researchers defined as persistent symptoms or more than one acute episode within the past 3 months despite reported use of medication.

Higher income did not guarantee optimal control. Most children from families with incomes in the $15,000–$44,999 range had inadequate therapy (42%) or suboptimal control (40%). Nearly a quarter of the children from families earning upward of $45,000 received inadequate therapy. About half had suboptimal control.

Listing factors that might lead to poor asthma control in the study population as a whole, Dr. Halterman reported 72% of the children lived with household triggers, 58% did not have an asthma management plan, and 16% had someone smoke in their homes during the week before a parent answered the survey.

In addition, 35% of all children with suboptimal control had poor medication adherence.

Discontinuous insurance coverage was the leading demographic factor associated with inadequate therapy for asthma (odds ratio 2.4), according to Dr. Halterman. Of the total study population, only 15% had discontinuous insurance coverage, but 56% of the poorest children did.

ELSEVIER GLOBAL MEDICAL NEWS

SAN FRANCISCO — A study of 975 asthmatic children in four states found only one child in five achieved optimal symptom control through use of preventive medication.

While 37% of the symptomatic children did not use any preventive medications, 43% had persistent symptoms despite parent reports that these children used their prescribed therapies, according to data Dr. Jill S. Halterman presented at the annual meeting of the Pediatric Academic Societies.

“We still have a lot of work to do to identify children with persistent asthma, and to ensure that they use effective preventive therapy,” said Dr. Halterman of the University of Rochester (N.Y.) and its Golisano Children's Hospital at Strong, also in Rochester.

She called the substantial number of children with poor asthma symptom control despite reported use of preventive medications “a newly highlighted concern.”

Dr. Halterman and her coinvestigators based their findings on parent responses to the Asthma Survey Form included in the 2003 State and Local Area Integrated Telephone Survey (SLAITS), a random-digit-dial survey. The sample covered Alabama, California, Illinois, and Texas.

For the analysis, the researchers selected parents of children aged 17 years and younger who had persistent symptoms according to national asthma guidelines and/or used preventive asthma medications (defined as inhaled corticosteroids, mast cell stabilizers, theophylline derivatives, leukotriene modifiers, and combined corticosteroids and long-acting β₂-agonists).

Poor children were at the highest risk of receiving inadequate therapy, according to Dr. Halterman's poster and a talk she gave at the meeting, which was sponsored by the American Pediatric Society, Society for Pediatric Research, Ambulatory Pediatric Association, and American Academy of Pediatrics.

More than half (53%) of children from families with incomes less than $15,000 a year did not use any medication and had persistent symptoms during the month before their parents were surveyed. Another 35% of poor children had suboptimal control, which the researchers defined as persistent symptoms or more than one acute episode within the past 3 months despite reported use of medication.

Higher income did not guarantee optimal control. Most children from families with incomes in the $15,000–$44,999 range had inadequate therapy (42%) or suboptimal control (40%). Nearly a quarter of the children from families earning upward of $45,000 received inadequate therapy. About half had suboptimal control.

Listing factors that might lead to poor asthma control in the study population as a whole, Dr. Halterman reported 72% of the children lived with household triggers, 58% did not have an asthma management plan, and 16% had someone smoke in their homes during the week before a parent answered the survey.

In addition, 35% of all children with suboptimal control had poor medication adherence.

Discontinuous insurance coverage was the leading demographic factor associated with inadequate therapy for asthma (odds ratio 2.4), according to Dr. Halterman. Of the total study population, only 15% had discontinuous insurance coverage, but 56% of the poorest children did.

ELSEVIER GLOBAL MEDICAL NEWS

SAN FRANCISCO — A study of 975 asthmatic children in four states found only one child in five achieved optimal symptom control through use of preventive medication.

While 37% of the symptomatic children did not use any preventive medications, 43% had persistent symptoms despite parent reports that these children used their prescribed therapies, according to data Dr. Jill S. Halterman presented at the annual meeting of the Pediatric Academic Societies.

“We still have a lot of work to do to identify children with persistent asthma, and to ensure that they use effective preventive therapy,” said Dr. Halterman of the University of Rochester (N.Y.) and its Golisano Children's Hospital at Strong, also in Rochester.

She called the substantial number of children with poor asthma symptom control despite reported use of preventive medications “a newly highlighted concern.”

Dr. Halterman and her coinvestigators based their findings on parent responses to the Asthma Survey Form included in the 2003 State and Local Area Integrated Telephone Survey (SLAITS), a random-digit-dial survey. The sample covered Alabama, California, Illinois, and Texas.

For the analysis, the researchers selected parents of children aged 17 years and younger who had persistent symptoms according to national asthma guidelines and/or used preventive asthma medications (defined as inhaled corticosteroids, mast cell stabilizers, theophylline derivatives, leukotriene modifiers, and combined corticosteroids and long-acting β₂-agonists).

Poor children were at the highest risk of receiving inadequate therapy, according to Dr. Halterman's poster and a talk she gave at the meeting, which was sponsored by the American Pediatric Society, Society for Pediatric Research, Ambulatory Pediatric Association, and American Academy of Pediatrics.

More than half (53%) of children from families with incomes less than $15,000 a year did not use any medication and had persistent symptoms during the month before their parents were surveyed. Another 35% of poor children had suboptimal control, which the researchers defined as persistent symptoms or more than one acute episode within the past 3 months despite reported use of medication.

Higher income did not guarantee optimal control. Most children from families with incomes in the $15,000–$44,999 range had inadequate therapy (42%) or suboptimal control (40%). Nearly a quarter of the children from families earning upward of $45,000 received inadequate therapy. About half had suboptimal control.

Listing factors that might lead to poor asthma control in the study population as a whole, Dr. Halterman reported 72% of the children lived with household triggers, 58% did not have an asthma management plan, and 16% had someone smoke in their homes during the week before a parent answered the survey.

In addition, 35% of all children with suboptimal control had poor medication adherence.

Discontinuous insurance coverage was the leading demographic factor associated with inadequate therapy for asthma (odds ratio 2.4), according to Dr. Halterman. Of the total study population, only 15% had discontinuous insurance coverage, but 56% of the poorest children did.

ELSEVIER GLOBAL MEDICAL NEWS