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Published on: November 4, 2010
Management of asthma in school-aged children and adolescents
Insights
Effective childhood asthma management relies on assessing severity and control, using evidence-based guidelines, and regular provider visits. Key strategies include trigger assessment, adherence review, and appropriate medication use for persistent asthma.
Area of Science:
- Pediatric Pulmonology
- Clinical Practice Guidelines
Background:
- Asthma is a prevalent childhood illness, causing significant morbidity and healthcare costs globally.
- Recent evidence-based guidelines have enhanced the consistency and effectiveness of pediatric asthma care.
Purpose of the Study:
- To outline fundamental principles for effective childhood asthma management.
- To emphasize the importance of assessing asthma severity and control.
Main Methods:
- Guideline review and synthesis of best practices for pediatric asthma care.
- Focus on assessment domains: impairment and risk.
- Recommendations for routine clinical encounters.
Main Results:
- Consistent application of guidelines improves asthma care outcomes.
- Regular assessment of triggers, comorbidities, inhaler technique, and adherence is crucial.
- Inhaled corticosteroids are primary controllers; discuss risks with caregivers.
Conclusions:
- Optimal management involves regular assessment, adherence to guidelines, and individualized treatment plans.
- Careful consideration of medication risks and benefits is essential.
- Referral to specialists is indicated for complex or difficult-to-treat cases.
Abstract:
Asthma is one of the most common childhood diseases in the world and a significant cause of morbidity and health care expenditures. United States and international evidence-based guidelines created and updated in the past 2 decades have significantly improved the consistency and effectiveness of asthma care in children. Assessing severity and monitoring control using the impairment and risk domains is fundamental to effective management. At every visit, the provider should assess environmental triggers and comorbid conditions, review inhaler technique and adherence, and provide an updated asthma action plan. Inhaled corticosteroids remain the preferred controller in persistent childhood asthma; however, especially in young children, a discussion should occur with caregivers regarding possible adverse effects. Similarly, if long-acting beta-2-agonists are added to inhaled corticosteroids at step 3 care and above, the risk of severe asthma-related events should be discussed. Indications for referral to an asthma specialist include difficult-to-treat asthma, step 4 care and above, risk factors for severe asthma related events, subtypes of asthma, and doubts of asthma diagnosis.
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