The impact of asthma in an inner city general practice

This study was undertaken to find out the problems which children with asthma experience at school and at home. Patient interviews with 32 asthmatic children aged between 6 and 16 years using a semi-structured questionnaire were carried out in an inner city practice in Bristol. Twenty-three (71.8%) children experienced exercise-induced bronchospasm which particularly upset them at school. Eleven of 14 (78.5%) secondary schoolchildren said not being able to participate in sport was the worst thing about having asthma. Children seemed to accept that their inability to participate in sport was normal. Fourteen primary schoolchildren (77.7%) had restricted access to their inhalers. Primary schoolchildren were upset most by coughing or wheezing. Of 21 children who said smoke made their asthma worse, 18 lived in households where someone smoked. Children were more distressed by how their asthma affected them at school than at home. Thirty-one (96.8%) of the children viewed their asthma negatively, although 26 (81.2%) felt they were in control of their asthma. School age children may have undiagnosed, exercise-induced bronchospasm causing considerable physical and psychological morbidity and are therefore being inadequately treated. Children's negative views of their asthma may be missed by conventional questioning and asthma clinics should ensure that children are encouraged to reveal the issues that concern them. Children should have easy access to their medication at school. Locally agreed management of asthma in schools may improve morbidity from asthma.