Asthmatic children may often be undermedicated

NEW YORK (Reuters Health) – Anti-inflammatory medication is helpful in certain asthmatic children, but misclassification of symptom severity may lead to their being deprived of such treatment, researchers report in the February issue of the Archives of Pediatrics and Adolescent Medicine.

In fact, lead author Dr. Jill S. Halterman told Reuters Health, that "although national guidelines recommend maintenance medications for all children with mild persistent to severe asthma, we know that many children who should receive these medications are not receiving them."

Dr. Halterman, of the University of Rochester School of Medicine and Dentistry, New York, and colleagues studied 90 children (ages 4 to 6 years) with mild persistent to severe persistent asthma symptoms. Most (67%) were black, and most (73%) were receiving Medicaid.

Assessment of the severity of symptoms and medications use was obtained from both parents and primary care providers. The parental and provider assessments were then compared. Only 40% of the children were accurately described by their providers as having mild persistent to severe persistent asthma. The remainder was described as having mild intermittent asthma.

Altogether, only 50% of children had been prescribed maintenance medication. However, 83% of children whose asthma severity was accurately described received such medication. This was true of only 28% of inaccurately classified children.

Children whose parents thought that the healthcare provider was aware of asthma symptom frequency were more likely to be accurately classified than those who did not (46% versus 20%). Similarly, children who had made an office visit within the previous 6 months were correctly classified more often than those who had not (47% versus 25%).

Summing up, Dr. Halterman pointed out that "the majority of children in our study were not accurately classified by their primary care providers as having mild persistent to severe asthma and subsequently weren't prescribed maintenance medications." It is likely, she added, "that efforts to enhance screening for asthma severity and improve communication between parents and providers would substantially improve adherence with asthma care guidelines."

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