Practical evaluation of asthma exacerbation self-management in children and adolescents

The objective of this study was to describe asthma exacerbation self-manage ment in children and adolescents. We used a cross-sectional study populatio n enrolled in the International Study of Asthma and Allergies in Childhood (ISAAC) in Bordeaux. Subjects answered an additional questionnaire on utili zation of health services, self-evaluation of usual asthma exacerbation sev erity and home management of asthma exacerbation. Criteria used for selecti ng patients were both having asthma confirmed by a physician and having had suffered from symptoms during the past year. Children and adolescents attended similar health services for managing thei r asthma but compliance to anti-asthmatic treatment was better in children than in adolescents. Among the children 4.8% had asthma and 6.2% of adolesc ents had asthma, as diagnosed by a doctor. Of the children, 72.3% and of th e adolescents 54.7% had less than one asthma attack per month. In cases of mild asthma exacerbation, 38.7% of adolescents and 9.3% of children waited until the end of exacerbation without taking any medication. The proportion of children not receiving any treatment was lower when symptoms were more severe but this was not the case in adolescents. Although most of the patie nts used were taking beta (2)-agonist, we found that 21-43% of children or adolescents did not receive appropriate medication in the event of asthma e xacerbation. These results demonstrate that (i) asthma exacerbation self-management is r elated to self-assessed severity of symptoms and that (ii) a large proporti on of asthmatic children in the community, and particularly adolescents, do not therefore receive appropriate treatment in the event of asthma exacerb ation.