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Asthma symptoms and medication in the PIAMA birth cohort: evidence for under and overtreatment

Daan Caudri1, Alet H Wijga, Henriette A Smit

  • 1Department of Pediatrics/Respiratory Medicine, Erasmus University, Rotterdam, The Netherlands.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|July 14, 2011
PubMed

Insights

Asthma undertreatment and overtreatment are common in young children. Many children with asthma symptoms did not receive appropriate inhaled medication, while others were treated unnecessarily.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Clinical Epidemiology

Background:

  • Under- and overtreatment of childhood asthma pose significant risks.
  • Longitudinal data on inhaled medication use versus asthma symptoms in young children are limited.
  • Accurate assessment of asthma management in early childhood is crucial.

Purpose of the Study:

  • To evaluate the concordance between inhaled medication use and asthma symptoms in children aged 2-8 years.
  • To identify patterns of under- and overtreatment in pediatric asthma management.
  • To provide longitudinal insights into asthma care for young children.

Main Methods:

  • Utilized data from the 'Prevention and Incidence of Asthma and Mite Allergy' birth cohort (n=3963).
  • Children were followed annually via postal questionnaires from age 2 to 8 years.
  • Assessed age-specific prevalences of asthma symptoms and compared them with reported use of inhaled bronchodilators and/or corticosteroids.

Main Results:

  • The prevalence of current wheeze decreased with age.
  • Approximately one-third of children experiencing wheeze did not use inhaled medication.
  • At age 8, 30% of children with severe asthma symptoms were not on inhaled corticosteroids, while 50% of those on long-term corticosteroids reported no wheezing.

Conclusions:

  • A substantial proportion of symptomatic children received inadequate treatment, even with severe or prolonged symptoms.
  • Overtreatment, indicated by corticosteroid use in asymptomatic children, increased with age, reaching 33% by age 8.
  • Findings indicate that both under- and overtreatment of asthma are prevalent in young children.
Abstract

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