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PubMed2006

Asthma programme in Finland: comparison of adult asthma referral letters in 1994 and 2001.

OBJECTIVES: The aim of the study was to evaluate the quality of asthma-related referral letters at the launch of the Asthma Programme in 1994 and 7 years later in 2001. METHODS: All referrals during 1 year (n=1121 in 1994, n=1136 in 2001) to one pulmonary department were screened in 2001. By the same inclusion criteria of asthma or suspicion of asthma, 624 letters (56% of all) from the year 1994 and 452 (40% of all) from the year 2001 were selected. The quality of study letters was assessed against the previously developed asthma referral letter criteria. Comparison of the referral letter quality in 1994 and 2001 was made. RESULTS: The proportion of poor letters decreased from 63% in 1994 to 44% in 2001, while that of good letters increased from 7% to 22%. Graphics of peak flow follow-up measurements (14% vs. 40%) and spirometry with bronchodilatation test (5% vs. 32%) were included significantly more often as an attachment. CONCLUSION: Lung functions are being measured more often in primary care, indication a more active detection of asthma. The number of asthma-related referrals in relation to all pulmonary consultation referrals decreased and their quality improved during the years of the Asthma Programme.

Adolescent↗
PubMed2004

Acute effects of urban ambient air pollution on respiratory symptoms, asthma medication use, and doctor visits for asthma in a cohort of Australian children.

We enrolled a cohort of primary school children with a history of wheeze (n=148) in an 11-month longitudinal study to examine the relationship between ambient air pollution and respiratory morbidity. We obtained daily air pollution (ozone, particulate matter less than 10 microm, and nitrogen dioxide), meteorological, and pollen data. One hundred twenty-five children remained in the final analysis. We used logistic regression models to determine associations between air pollution and respiratory symptoms, asthma medication use, and doctor visits for asthma. There were no associations between ambient ozone concentrations and respiratory symptoms, asthma medication use, and doctor visits for asthma. There was, however, an association between PM(10) concentrations and doctor visits for asthma (RR=1.11, 95% CI=1.04-1.19) and between NO(2) concentration and wet cough (RR=1.05, 95% CI=1.003-1.10) in single-pollutant models. The associations remained significant in multipollutant models. There was no consistent evidence that children with wheeze, positive histamine challenge, and doctor diagnosis of asthma reacted differently to air pollution from children with wheeze and doctor diagnosis of asthma and children with wheeze only. There were significant associations between PM(10) levels and doctor visits for asthma and an association between NO(2) levels and the prevalence of wet cough. We were, however, unable to demonstrate that current levels of ambient air pollution in western Sydney have a coherent range of adverse health effects on children with a history of wheezing.

Air Pollution↗
PubMed2002

Ways of coping with asthma in everyday life: validation of the Asthma Specific Coping Scale.

OBJECTIVE: This study examines the validity of the Asthma Specific Coping Scale. METHODS: Study samples were comprised of persons with drug-treated asthma (n=3464) drawn from the Drug Reimbursement Registry and asthma rehabilitation participants [brief (n=278) and comprehensive (n=316) intervention]. Data were collected by questionnaires. RESULTS: The expected structure of the six subscales (restricted lifestyle, hiding asthma, positive reappraisal, information seeking, ignoring asthma, and asthma worry) was supported. The Cronbach's alpha reliabilities of the subscales ranged from .63 to .84. Concurrent validity was supported by meaningful correlations between asthma coping scales and psychosocial resources, health-related quality of life, and general coping. The asthma coping scales discriminated between the intervention participants and the population-based sample. Four out of six subscales also showed sensitivity to change after rehabilitation. CONCLUSION: Though further longitudinal studies are needed, this scale seems to be a promising instrument to be used in surveys and outcome studies.

Activities of Daily Living↗
PubMed1999

Asthma nurse practice--a resource-effective approach in asthma management.

The objective of this study was to evaluate the efficacy of an Asthma Nurse Practice (ANP) in primary health care. A 12-month (September 1994-August 1995) open, prospective intervention study with pre- and post-test comparisons was performed on patients with asthma treated at a primary care centre in Sweden. Sixty-three patients with mild or moderate asthma participated and medication, structured follow-up and education in self-management at an ANP were assessed over a 12-month period. The main outcome measures assessed were pulmonary function, eosinophil cationic protein (ECP) in serum, respiratory symptoms, patient knowledge of asthma and emergency visits. ANP in primary health care increased patient knowledge of asthma and medication. The number of patients with nocturnal symptoms decreased significantly. Pulmonary function was improved: vital capacity (VC) 98-106, forced expiratory volume in 1 sec (FEV1) 93-100 and peak expiratory flow (PEF) 98-115% of predicted (P < 0.001). Variation in PEF fell from 21 to 12% (P < 0.001). ECP was significantly reduced. Visits to the emergency room were 60% fewer during the year of intervention (P < 0.01). In conclusion, patients attending an Asthma Nurse Practice, comprising a structured programme for asthma management, improve their knowledge and asthma control.

Adult↗
PubMed2005

Validation of the Spanish and English versions of the asthma portion of the Brief Pediatric Asthma Screen Plus among Hispanics.

BACKGROUND: The health and health care needs of non-English-speaking Hispanic families with children are poorly understood, in part because they are often excluded from research owing to language barriers. Instruments that are valid in English and Spanish are necessary to accurately evaluate the magnitude of asthma prevalence and morbidity among Hispanics. OBJECTIVE: To establish the sensitivity and specificity of the English and Spanish versions of the asthma portion of the Brief Pediatric Asthma Screen Plus (BPAS+) in a low-income Hispanic population. METHODS: The validation sample consisted of 145 children whose parents completed the BPAS+ in Spanish and 78 whose parents completed it in English. Bilingual clinicians conducted the examinations on which the clinical assessments were based. We compared the BPAS+ results with the clinical assessment findings to determine the sensitivity and specificity of the BPAS + among Hispanics in terms of identifying children who warrant further medical evaluation for asthma. RESULTS: The sensitivity and specificity of the asthma portion of the Spanish BPAS+ were 74% and 86%, respectively. The sensitivity and specificity of the asthma portion of the English BPAS+ were 61% and 83%, respectively. CONCLUSIONS: The asthma portion of the BPAS+, a valid screen for identifying children who are in need of further evaluation for potentially undiagnosed asthma, is valid for low-income Hispanics in Spanish and English. As the Hispanic population continues to grow, it is imperative that researchers have English and Spanish instruments that are valid for this population.

Asthma↗
PubMed2003

The impact of a large-scale population-based asthma management program on pediatric asthma patients and their caregivers.

BACKGROUND: The consequences of pediatric asthma include missed school attendance, limitations in physical activity, and increased health care utilization and costs. Caregivers of asthmatic children are affected through missed work days and decreased job productivity. In response to these issues, a disease management program encompassing asthmatic children and their caregivers was developed as part of the core services offered to members of a large, national health care plan. OBJECTIVE: To determine the impact of the asthma management program on pediatric asthma patients and their caregivers over a 12-month period. METHODS: In this longitudinal study, 401 randomly selected member households with asthmatic children from 17 regional markets completed surveys before and after 12 months of participation in the asthma management program. Program interventions, which were tailored according to risk and need status, included various staggered educational mailings, reminder aids, videos, a peak expiratory flow rate meter, and telephonic case management. The Asthma Quality Assessment System survey, a battery of self-reported quality indicators, was used to solicit information from parents or caregivers of asthmatic children on issues pertaining to quality of life, asthma management skills and knowledge, and lost work/school days related to asthma. RESULTS: Statistically significant postprogram outcomes were observed in various domains, including a reduction in adverse utilization, symptomatology, and restricted activity days for children and lost work days for adult caretakers. CONCLUSIONS: These findings demonstrate that a large-scale population-based intervention program can produce measurable clinical and economic benefits, thereby lessening the burden of asthma on the family unit.

Absenteeism↗
PubMed2000

Prevalence of asthma, allergic rhinitis, and eczema in 13- to 14-year-old children in Kuwait: an ISAAC study. International Study of Asthma and Allergies in Childhood.

OBJECTIVES: To determine the prevalence of asthma and allergic diseases in 13 to 14 years old children in Kuwait. DESIGN: Supervised self-administered written and video questionnaires of the international study of asthma and allergies in childhood (ISAAC). SUBJECTS: Students at third and fourth years from 40 intermediate level schools chosen randomly from across Kuwait. RESULTS: 3,110 students were surveyed. The prevalence rates (95% CI) in the written questionnaire for wheeze ever, current wheeze (within the last 12 months), and physician diagnosis of asthma are 25.9% (24.5 to 27.4), 16.1% (15.8 to 17.4), and 16.8% (15.5 to 18.1) respectively. The prevalence rates (95% CI) for symptoms of allergic rhinitis (AR) ever, current symptoms of allergic rhinitis (AR), and diagnosis of AR are 43.9% (42.2 to 45.6), 30.7% (29.1 to 32.4) and 17.1% (14.8 to 18.4) respectively. The prevalence rates (95% CI) for itchy rash ever, current itchy rash, and diagnosis of eczema are 17.5% (16.2 to 18.8), 12.6% (11.4 to 13.8), and 11.3% (10.2 to 12.4) respectively. The prevalence of wheeze ever, wheeze during the last year, and physician diagnosis of asthma are higher in males compared with females, P < .01. In multiple logistic regression: male gender (OR 1.6, 95% CI, 1.3 to 2.0) and diagnosis of AR (OR 1.7, 95% CI, 1.4 to 2.2) were associated with the physician diagnosis of asthma even after controlling for symptoms of asthma. CONCLUSION: This is the first study on the prevalence of allergic diseases in Kuwait and it shows that children in Kuwait have a moderate prevalence of asthma, AR, and eczema compared with other countries where the ISAAC study is done. The prevalence of asthma is higher in boys compared with girls.

Adolescent↗
PubMed2000

Asthma severity, psychophysiological indicators of arousal, and immune function in asthma patients undergoing biofeedback-assisted relaxation.

Asthma is characterized by airway hyper-responsiveness, inflammation, and reversible obstruction. Respiratory tract infection, allergies, air pollution, and psychosocial factors impact the severity and frequency of asthma symptoms. Pharmacotherapy and self-care are the major components in the management of asthma, but behavioral interventions also have the potential to affect asthma morbidity. We conducted a small, randomized controlled study, examining the effects of biofeedback-assisted relaxation in 16 nonsmokers with nonsteroid-dependent mild asthma. Data were collected on asthma symptoms, pulmonary function, indicators of arousal, and cellular immune factors. The trained group evidenced a decrease in forehead muscle tension in comparison to the controls, but no changes in peripheral skin temperature. Decreases in asthma severity and bronchodilator medication usage for the experimental group were observed. Pulmonary function testing revealed a significant difference between groups in FEV1/FVC at posttest, with the E group having a higher ratio than the controls. The cellular immune data showed no significant group differences in total white blood cell or lymphocyte counts, but decreases over time were observed. Significant differences were observed in the numbers of neutrophils and basophils in the trained group compared to controls, which supports the concept of decreased inflammation. Results of delayed-type hypersensitivity skin testing suggested enhanced function, but they were not conclusive. These findings, though limited by size of population, suggest a positive effect of biofeedback-assisted relaxation in young, nonsteroid-dependent asthmatics. The mechanisms underlying linkages between psychological, behavioral, and immune responses in asthma require further study.

Adolescent↗
PubMed2000

The relationship between asthma severity, family functioning and the health-related quality of life of children with asthma.

This study compared the health-related quality of life (HRQL) of 236 children with mild or moderate/severe asthma with that of a large representative sample of children in the general community. The study also examined the relationship between the HRQL of children with asthma and their demographic characteristics, asthma severity and family functioning. Children with asthma had a significantly poorer HRQL than other children in the community. Amongst the children with asthma, parents reported that children living in single-parent families had poorer physical health, mental health and social functioning than children in two-parent families. There was a significant relationship between the mental health of children with asthma and family functioning but no significant relationship between their physical health and family functioning. These findings suggest that the domains comprising the HRQL of children with asthma are related to both disease and non-disease factors. A better understanding of these relationships will facilitate the development of new interventions to help children with asthma.

Asthma↗
PubMed1997

Discriminative aspects of two generic and two asthma-specific instruments: relation with symptoms, bronchodilator use and lung function in patients with mild asthma.

The objective of this study was to compare the two most frequently used asthma-specific quality of life (QOL) questionnaires and two generic QOL questionnaries with clinical data in order to establish their ability to discriminate in asthma severity, also referred to as cross-sectional construct validity. We conducted a multicentre, randomized, placebo-controlled study investigating the long-term effects of the long-acting beta 2-agonist formoterol in asthma patients using inhaled corticosteroids and short-acting beta 2-agonists. Before randomization, the peak expiratory flow (PEF) and use of beta 2-agonists for relief of symptoms were recorded twice daily for 1 month. At the end of the run-in period, the forced expiratory volume in 1 s (FEV1), airway hyper-responsiveness (PC20 methacholine) and QOL were measured, using two asthma-specific questionnaires, the Asthma Quality of Life Questionnaire (AQLQ) and the Living with Asthma Quality of Life Questionnaire (LWAQ), as well as two generic questionnaires, the Short Form 36 (SF-36) and the Psychological General Well Being (PGWB) index. The quality of life of the patients (n = 110) was only mildly impaired. The mean symptom score was 3.6 on a scale of 0-21 and the mean FEV1 was 65% of that predicted. The correlations between the QOL parameters and objective measures of asthma severity, such as the FEV1, PEF and PC20, were low (0.01-0.37). The correlations between the QOL parameters and subjective measures of asthma severity, such as symptom scores (range 0.26-0.65) and beta 2-agonist use for the relief of symptoms (0.09-0.39), were higher. The correlations of the activity and symptoms domains of the AQLQ with diary-obtained symptom scores were r = 0.50 (p < 0.0001) and r = 0.65 (p < 0.0001), respectively. The correlation between the physical construct of the LWAQ and symptom scores was r = 0.42 (p < 0.001) and that between the physical sumscore of the SF-36 and symptom scores was r = 0.50 (p < 0.001). The correlation between the PGWB and symptom scores was r = 0.41 (p < 0.001). The relation between the FEV1, PEF and PC20 and QOL was very low. The QOL measurements related well to the symptom scores. The AQLQ had a better cross-sectional construct validity than the LWAQ. The cross-sectional construct validity of the SF-36 was surprisingly high for this group of patients and the SF-36 performed better than the PGWB and LWAQ.

Adrenergic beta-Agonists↗
PubMed2000

Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma.

There is a subset of patients with bronchial asthma who are susceptible to disease exacerbation upon receiving aspirin and other nonsteroidal anti-inflammatory drugs. This is a clinical syndrome, called aspirin-induced asthma (AIA), associated with alterations in arachidonate metabolism and cysteinyl-leukotriene overproduction. The natural history and clinical characteristics of this type of asthma were studied. Sixteen clinical centres in 10 European countries provided standardized information to the specially developed patient-oriented database regarding: medical history, physical examination, diagnosis, and treatment. Diagnosis of AIA was based on a typical history, confirmed by positive aspirin provocation tests, carried out in 91% of the patients. A total of 500 patients were enrolled in the study. AIA developed according to a pattern, characterized by a sequence of symptoms. First, persistent rhinitis, appearing at a mean age of 29.7+/-12.5 yrs, then asthma, aspirin intolerance and nasal polyposis appear. The clinical presentation in different European countries was remarkably similar. In females, who outnumbered males by 2.3:1, the onset of symptoms occurred significantly earlier and the disease was more progressive and severe than in males. Atopy, present in approximately a third of patients, led to earlier manifestation of rhinitis and asthma, but not of aspirin intolerance or nasal polyposis. A family history of aspirin intolerance, recorded in 6% of patients, had a less evident effect on the course of the disease than sex or atopy. Fifty one per cent of patients, in addition to inhaled steroids, required chronic systemic corticosteroid therapy at a mean dose of 8 mg prednisone x day(-1). Surprisingly, 15% of patients were unaware of intolerance to aspirin and learnt about it only after having provocation tests performed. All over Europe, aspirin-induced asthma develops in a similar characteristic way. Its course is influenced by sex and the presence of atopy. In half of the patients, asthma is severe, and steroid-dependent. The uniform natural history of aspirin-induced asthma might suggest a common underlying principle.

Adolescent↗
PubMed1999

Immunogenetics of atopic asthma: association of DRB1*1101 DQA1*0501 DQB1*0301 haplotype with Dermatophagoides spp.-sensitive asthma in a sample of the Venezuelan population.

BACKGROUND: Genes linked to the major histocompatibility complex (MHC), have been implicated in atopic asthma. Asthma is highly prevalent in the Venezuelan population (estimated at 20%) and genetic markers are needed to identify populations at risk and plan intervention strategies. OBJECTIVE: To study the influence of the MHC class I and class II genes in the susceptibility to atopic asthma. METHODS: MHC-class I HLA-A, -C, -B and MHC-class II HLA-DR, -DQ, -DP gene haplotype frequencies were determined in 135 Venezuelan mestizos, 71 belong to 20 atopic asthmatic families and 64 unrelated controls. The index cases were 20 atopic asthmatics with positive skin-prick tests and specific serum immunoglobulin E (IgE) for Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To ascertain the genes associated with susceptibility to atopy and/or asthma, two control groups were studied, 41 non-atopic subjects with skin-prick negative test, and undetectable levels of specific IgE and 23 non-asthmatic atopic subjects with detectable specific IgE to Der p and Der f. A linkage analysis was performed in those families with two or more atopic siblings (with or without asthma). RESULTS: MHC-class I genes analysis showed that HLA-Cw7 was absent in the asthmatic patients studied, whereas the frequency of this allele was 14.3% in non-atopic controls (P = 0.0 17, PC = 0.19) and 20.8% in the atopic controls (P = 0.0066, PC = 0.07). MHC-class II gene analysis showed a significant increase of the HLA-DRB1*11 in the asthmatic patients compared with non-atopic controls (allele frequencies of 25.6 vs 4.4% P = 0.0017, PC = 0.02). There were no significant differences among asthmatic and atopic controls in the frequency of HLA-DRB1*11 (25.6 vs 17.4%). In contrast, the HLA-DRB1*1101+ haplotypes were significantly higher in asthmatics compared with atopic and non-atopic controls (19.6% vs 2.2% vs 2.3%, PC<0.05). The HLA-DRB1*1101, DQA1*0501, DQB1*0301 haplotype was found significantly increased in the patients vs non-atopic controls (15.4 vs 1.1%, PC< 0.01). The serum levels of specific IgE were detectable in both atopic asthmatics and atopic controls; however, it was higher in atopic asthmatics vs atopic controls Der p (median, 58.7 vs 2.7 kU/L, P<0.001) and Der f (median, 46.9 vs 2.7 kU/L, P<0.001). No linkage between MHC genes and mite-atopy could be documented on informative families with two or more atopic siblings. CONCLUSIONS: We have identified an association between the haplotype HLA-DRB1*1101, DQA1*0501, DQB1*0301 and atopic asthma that confers susceptibility to develop mite-sensitive asthma to atopics (relative risk, RR 8.2), and to non-atopic controls (RR = 15.8) that carry this haplotype. Conversely, the allele HLA-Cw7 was absent in the asthmatics studied and had higher frequencies in the atopic (RR = 0.05) and non-atopic (RR = 0.08) controls. Thus, it may have a protective role for developing atopic asthma in the population studied.

Adolescent↗
PubMed2001

Asthma, asthma medication and autonomic nervous system dysfunction.

Asthma is associated with autonomic nervous imbalance: an increased bronchial sensitivity to cholinergic constrictors and possibly a decreased sensitivity to beta2-adrenergic dilators have been reported in this disease. Also, non-adrenergic and non-cholinergic (NANC) mediators have a small regulatory effect on airway function. These mediators contribute to the pathogenesis of asthma not only by regulating smooth muscle tone in the airways but also by affecting pulmonary blood flow, endothelial permeability and airway secretions. In many studies increased parasympathetic responsiveness has been associated with clinical asthma or the worsening of asthma in adults. However, most of the studies in children have not found association between autonomic dysfunction and asthma. Therefore, the autonomic dysfunction in asthma may be related to more advanced disease or long-term asthma medication in adults. This article briefly reviews the relationships between airway inflammation, beta2-agonist, anticholinergic and glucocorticoid medication as well as autonomic nervous function in asthma.

Adrenergic beta-Agonists↗
PubMed2002

Differences in trigger factors and symptoms between patients with asthma-like symptoms and patients with asthma: development of a basis for a questionnaire.

Patients with asthma-like symptoms but with negative asthmatests are often misdiagnosed as having asthma and treated as asthmatics. They describe their trigger factors and symptoms very similar to those of patients with asthma. The aim of the study was to analyze differences in symptoms and trigger factors between asthma-like patients and asthmatics in order to elaborate a basis for a questionnaire for epidemiological and clinical use. A questionnaire with 54 questions about trigger factors and 137 questions about symptoms was sent to 40 patients with asthma-like symptoms and 40 with asthma, all consecutively selected from patients referred to an out-patient clinic for asthma and allergy for investigation of suspected asthma. Data were analyzed statistically in two steps using multiple logistic regression analysis. Significant differences were seen in several trigger factors and symptoms after the first analysis. After the second analysis, seven out of the 54 trigger factors and 22 out of the 137 symptoms emerged as those that most significantly discriminated between the two patient groups. These trigger factors and symptoms can be the basis of a new questionnaire with high discriminating power. Before using it, it is important to evaluate the best combination of variables, add some demographic variables and totestthe reliability and validity ofthis new questionnaire.

Adult↗
PubMed1996

Comparison of regularly scheduled with as-needed use of albuterol in mild asthma. Asthma Clinical Research Network.

BACKGROUND: Inhaled beta-agonists are the most commonly used treatment for asthma, but data suggest that regularly scheduled use of these agents may have deleterious effect on the control of asthma. We compared the effects of regularly scheduled use of inhaled albuterol with those of albuterol used only as needed in patients with mild chronic, stable asthma. METHODS: In a multicenter, double-blind study, we randomly assigned 255 patients with mild asthma to inhale albuterol either on a regular schedule (126 patients) or only as needed (129 patients). The patients were followed for 16 weeks. RESULTS: The primary outcome indicator, peak expiratory air flow measured in the morning, did not change significantly during the treatment period in the scheduled (416 liters per minute after the run-in period and 414 liters per minute after the treatment period) or the as-needed (424 liters per minute at both times) treatment groups (P=0.71). There were no significant differences between the two groups in peak flow variability, forced expiratory volume in one second, the number of puffs of supplemental albuterol needed, asthma symptoms, asthma quality-of-life score, or airway responsiveness to methacholine. The statistically significant differences between the groups in evening peak flow and in the short-term bronchodilator response to inhaled albuterol were small and judged to be clinically unimportant. CONCLUSIONS: In patients with mild asthma, neither deleterious nor beneficial effects derived from the regular use of inhaled albuterol beyond those derived from use of the drug as needed. Inhaled albuterol should be prescribed for patients with mild asthma on an as-needed basis.

Administration, Inhalation↗
PubMed2005

Asthma patients' knowledge, perception, and adherence to the asthma guidelines.

Asthma patients' knowledge and perceptions about asthma management regimens have been shown to correlate with the quality of their asthma management and outcomes. This study addresses adult ambulatory asthma patients' knowledge and perception of the asthma management guidelines issued by the National Asthma Education and Prevention Program. We interviewed 76 patients at three adult medicine outpatient clinics. Of 37 patients who knew about peak flow monitoring, 21 found it to be useful, only 10 were using it regularly, and 7 had a notation about it in their chart. Eight patients knew about patient self-assessment forms, 6 found them useful, 3 had used one recently, and only 1 patient had one in the chart. Six patients knew about asthma action plans, 4 of them thought that these plans were useful, but only 1 patient was actively using it. This study demonstrates major gaps in the asthma patients knowledge, perceptions, and their adherence to recommendations and also with the documentation in the medical record.

Anti-Inflammatory Agents↗
PubMed2001

Children with asthma and nebulizer use: parental asthma self-care practices and beliefs.

We examined demographic characteristics, patterns of medication use, asthma morbidity, and asthma self-management practices and beliefs among inner-city children currently using a nebulizer. We also describe the relationship between asthma self-management practices and beliefs and anti-inflammatory (AI) therapy. We observed a high rate of morbidity, including frequent emergency room visits, hospitalizations, symptom days and nights, and school absences in this group of school-aged children with asthma. More than three-quarters (81%) reported asthma symptoms consistent with mild persistent or greater severity of asthma, and therefore these subjects should be taking AI medications. Another 16% (36 of 231) of these children reported symptoms consistent with mild intermittent asthma. Only 1 out of 7 children in this study reported taking AI medications. We found that parents of children taking daily AI medications were more likely to agree with the belief that children should use asthma medications daily even when the child is not reporting any symptoms.

Administration, Inhalation↗
PubMed2005

Prevalence of asthma and asthma-like symptoms in inner-city schoolchildren.

This study investigates the prevalence of asthma and asthma-related symptoms in New Orleans inner-city schoolchildren. A cross-sectional survey of 1535 elementary, middle, and high school children (aged 5-18) was conducted by using the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire. Lifetime prevalence of wheezing was 39.4%, and lifetime prevalence of asthma was 24.4%. Wheezing during the previous 12 months was reported by 25.7% of the sample. Twenty-one percent of respondents reported having one or more attacks of wheezing per year, with 5.6% reporting four or more attacks per year. Many participants reported sleep disturbance (15.4%), with 6.2% reporting sleep disturbance more than once a week. The 12-month rate of speech limitation due to asthma exacerbation was 6.6%. Exercise-induced asthma was reported by 16.9% of the students, and nocturnal cough (not associated with cold) was reported by 27.3%. Overall, boys reported higher rates of symptoms than girls, and younger children (aged 6-7) reported greater symptoms than older children (aged 13-14). These findings show that prevalence of asthma in this population is elevated, and the ISAAC written questionnaire successfully identified inner-city children at risk for asthma in New Orleans.

Adolescent↗