Monitoring asthma in children

Abstract

The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist in various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence. @ERSpublications ERS statement summarising and discussing the available literature on monitoring children with asthma

Asthma control in London secondary school children

“…Since suboptimal control by ACT is a risk factor for future severe exacerbations [6], and should prompt more intense clinical monitoring [7], our results suggest a need for interventions aimed at addressing poor asthma control in UK schoolchildren.…”

“…This cut-off is also associated with an increased risk of urgent health care use for asthma over a subsequent six months (adjusted odds ratio; 2.29 (95% CI 1.45 to 3.62)) [6]. Indeed, a recent European Respiratory Society Task Force recommends that an ACT score of ࣘ19 in a child should trigger more intense clinical monitoring [7].…”

Modern Strategies for the Therapy of Persistent Bronchial Asthma in Adolescents

“…ОСНОВНЫЕ ЦЕЛИ ТЕРАПИИ БРОНХИАЛЬНОЙ АСТМЫ И ПРЕПЯТСТВИЯ К ИХ ДОСТИЖЕНИЮ Несмотря на наличие согласительных документов, руководств и эффективных препаратов для лечения БА, у многих пациентов не удается достичь хорошего контро-ля заболевания [10,11]. Одними из главных причин пер-систирования симптомов астмы являются отсутствие или низкая степень приверженности к назначенной тера-пии и низкий уровень взаимодействия между врачом и пациентом [12,13].…”

Asthma in childhood

“…Numerous tools can be used, including spirometry, biomarkers, airway hyperresponsiveness and validated questionnaires. However, the evidence of the utility of most of these tools is lacking, particularly in children, and there is limited evidence as to how the various components of control should be integrated [37]; in addition, studies tend to evaluate each measure in isolation. In order to evaluate possible benefits of web-based monitoring, VOOREND-VAN BERGEN et al [38] conducted a multicentre, prospective, partly blinded, parallel group, three-arm RCT on monitoring strategies in 268 asthmatic children aged 4-18 years, with a follow-up of 1 year (Better Asthma Treatment: Monitoring with ACT and Nitric oxide (BATMAN) study).…”