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Changing trends in approach to wheezy children by family doctors
H J Steen1, M C Stewart, D McAuley
1Dept of Child Health, Queen's University of Belfast.
Insights
Increased awareness of childhood asthma symptoms has led to earlier diagnosis and reduced antibiotic use in young children. This study found earlier diagnosis and appropriate bronchodilator treatment, even in undiagnosed cases.
Area of Science:
- Pediatrics
- Respiratory Medicine
- General Practice
Background:
- The prevalence of childhood asthma has significantly increased over the last two decades.
- This rise may be partly attributed to earlier recognition and reclassification of symptoms like wheezing.
- Antibiotic overuse for respiratory symptoms in young children is a concern.
Purpose of the Study:
- To investigate if heightened awareness of asthma presentations in young children has resulted in earlier family doctor diagnoses.
- To determine if this increased awareness has led to a decrease in antibiotic prescriptions before bronchodilator introduction.
- To assess the prevalence of asthma and the timing of diagnosis and treatment in children aged 0-5 years.
Main Methods:
- Retrospective analysis of family doctor records for 769 children aged 0-5 years.
- Independent pediatrician review of medical records.
- Examination of documented wheezing episodes, asthma diagnoses, antibiotic courses, and bronchodilator use.
Main Results:
- 10.5% of children studied were diagnosed with asthma.
- One-third of the children had at least one documented episode of wheeze.
- The mean age of asthma diagnosis was 2.59 years, with bronchodilators introduced at a mean age of 2.22 years. Notably, 22 children without a recorded asthma diagnosis received appropriate bronchodilator treatment.
Conclusions:
- Increased awareness of asthma symptoms in young children appears to facilitate earlier diagnosis by family doctors.
- There is evidence suggesting a potential decrease in unnecessary antibiotic prescriptions prior to appropriate bronchodilator therapy.
- The study highlights the importance of timely diagnosis and appropriate management of pediatric asthma, even in cases initially presenting without a formal diagnosis.
Abstract:
The prevalence of asthma in children appears to have increased dramatically over the past 20 years. There is evidence that some of this increase is due to earlier recognition and relabeling of symptoms such as wheeze. In this study we set out to see if increased awareness of the presentation of asthma in young children has led to earlier diagnosis by family doctors and a decrease in the number of courses of antibiotics given before the introduction of bronchodilators. The family doctor records of 769 children aged 0-5 years were examined retrospectively by an independent paediatrician. One third had at least one documented episode of wheeze and the prevalence of asthma was 10.5%. The mean age of diagnosis was 2.59 years although the mean age at which bronchodilators were introduced was 2.22 years. 22 children, who were never recorded as being asthmatic, were nevertheless appropriately treated with bronchodilators.