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Childhood asthma: diagnosis and treatment
1Department of Pediatric Respiratory Disease and Allergy, Emma Children's Hospital AMC, Meibergdreef 7, 1105 AZ Amsterdam, The Netherlands.
Insights
Childhood asthma significantly impacts quality of life. Achieving asthma control is key, but non-adherence to therapy is a major barrier, highlighting the need for parent-child partnerships.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Allergy and Immunology
Background:
- Recurrent respiratory symptoms like coughing and wheezing affect many children, with a significant portion developing asthma by school age.
- Asthma significantly impacts a child's quality of life, affecting sleep, physical activity, social engagement, and family dynamics.
- Despite established treatment goals, achieving complete asthma control remains a challenge for many pediatric patients.
Purpose of the Study:
- To review the challenges in achieving optimal asthma control in children.
- To emphasize the importance of adherence and parent-child partnerships in asthma management.
- To outline current non-pharmacological and pharmacological approaches to pediatric asthma.
Main Methods:
- Review of current literature and clinical guidelines on pediatric asthma management.
- Analysis of factors contributing to therapy failure, including diagnosis, comorbidities, and adherence.
- Discussion of non-pharmacological strategies (e.g., smoke avoidance, allergen avoidance) and pharmacological guidelines (e.g., GINA, British Guideline).
Main Results:
- Non-adherence to asthma therapy is identified as the primary reason for treatment failure in the majority of cases.
- Successful asthma control requires a collaborative approach, involving setting individualized goals with parents and children.
- Non-pharmacological interventions and adherence to international guidelines are crucial for effective pharmacological management.
Conclusions:
- Improving asthma control in children necessitates addressing non-adherence through enhanced patient-provider partnerships.
- Individualized therapy goals and consistent application of evidence-based guidelines are essential for managing pediatric asthma.
- A comprehensive approach combining environmental control, adherence support, and guideline-based pharmacotherapy is vital for improving children's quality of life.
Abstract:
Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.
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