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Childhood asthma control in Japan: A nationwide, cross-sectional, web-based survey
Koichi Yoshida1, Mari Sasaki1, Yuichi Adachi2
1Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Insights
Many Japanese children have uncontrolled asthma despite controller medications. This study highlights gaps in asthma management and medication use for pediatric patients in Japan, impacting quality of life.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Epidemiology
Background:
- Asthma significantly impacts children's quality of life, with many experiencing uncontrolled symptoms.
- Limited large-scale population studies exist on pediatric asthma control in Japan.
Purpose of the Study:
- To assess asthma control levels in Japanese children.
- To analyze asthma controller medication patterns in this population.
Main Methods:
- A 2012 web-based survey of 6-11 year olds with asthma in Japan.
- Evaluation of asthma control using the Childhood Asthma Control Test (C-ACT).
- Classification of asthma control: uncontrolled (≤19), well-controlled (20-22), optimally controlled (>22).
Main Results:
- Of 3,033 children, 14.6% had uncontrolled asthma.
- 45.7% used controller medications, including 21.0% using inhaled corticosteroids.
- Among uncontrolled cases, 15.2% received no medication; 27.0% of those on medication remained uncontrolled.
Conclusions:
- Over half of Japanese children achieved optimally controlled asthma.
- A significant portion of children, both on and off medication, experienced uncontrolled asthma.
- Gaps in controller medication use and effectiveness were identified.
Background:
Recent surveys have shown that many patients with asthma experience uncontrolled symptoms and decreased quality of life due to their disease. However, few large population-based studies have evaluated asthma control in Japanese children.
Objective:
To show the reality of asthma control and the pattern of asthma controller medication use among Japanese children.
Methods:
In 2012, a web-based survey was conducted to identify children aged 6 to 11 years with asthma in Japan. Among children with current asthma, we collected information regarding their asthma controller medication use and evaluated the control level of asthma using the Childhood Asthma Control Test (C-ACT). In this study, a C-ACT score of 19 or less, 20 to 22 and over 22 were classified as uncontrolled asthma, well-controlled asthma, and optimally controlled asthma, respectively.
Results:
Among the 3,033 children with current asthma, 442 (14.6%), 635 (20.9%), and 1,956 (64.5%) children had uncontrolled, well-controlled, and optimally controlled disease, respectively. In the past 1 month, 1,387 (45.7%) reported receiving at least 1 asthma controller medication with 638 (21.0%) reported receiving inhaled corticosteroid. Among the children with uncontrolled asthma, 67 (15.2%) were not receiving any asthma controller mediations. Among children receiving asthma controller medication, 27.0%, 31.4% and 41.5% had uncontrolled, well-controlled, and optimally controlled asthma, respectively.
Conclusions:
Although more than half of children with current asthma had optimally controlled disease, some children without any controller medications and more than a quarter of the children receiving asthma controller medications had uncontrolled disease.
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