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Asthma talk needed

Doctors need to educate parents about the side effects of children's asthma treatments

There is a vast chasm in communication between doctors and parents worldwide with regard to understanding the severity of asthma in children. This is also true with regard to the benefits of compliance with treatment, according to the first global survey on unmet needs in this area.

A striking statistic that may shock unwary parents is that as many as 33 in every 100 fatal asthma attacks occur in children who are believed to have mild asthma, a disease whose prevalence is growing by around 50 per cent every 10 years and whose economic cost is greater than tuberculosis and HIV/AIDS combined, according to newly published research.

Results from the 16-country, 5,482-respondent Global Asthma Physician and Patient Survey (GAAP) have revealed that not only do parents underestimate the severity of their children's asthma, they also overestimate the potential control imbued by medicines.

Communication problem
This situation could be improved by oiling the mechanism of communication between parents and doctors, helping to educate people about the risks of the disease.

The findings suggest that there is much room to improve this dialogue in every country we studied, said Dr G Walter Canonica, of the University of Genova, Italy, for the World Allergy Organisation, adding that the place to start is in the area of treatment side effects, which have a big impact on compliance.

In many cases, parents are not able to identify these side effects, he said.

Two-thirds of parents who responded to the GAAP telephone survey admitted to having `rarely or never' discussed the potential long-term side effects with their children's physician, and some 58 per cent said they had rarely or never even discussed the possible short-term side effects of any medications prescribed.

However, it is notable that some 86 per cent of doctors who responded said they 'sometimes or always' discuss the short-term side effects with parents, and 65 per cent said they talk about longer term issues.

Further discrepancy creeps in to the respective stories when you consider that where such discussions are undertaken, the majority of parents say they are the ones to kick it off, while nearly three-quarters (69 per cent) of doctors say that it is they who initiate the dicussion.

The survey also revealed, worryingly, that when parents recognise side effects, or become concerned for their child's welfare in this respect, a lack of compliance is often the result.

Almost 30 per cent of patients who have experienced at least one side effect from their asthma medication have skipped doses, and 15 per cent of patients have even discontinued treatment.

The way we currently treat asthma is unsatisfactory, commented Dr Erkka Valovirta, a paediatric specialist at Turku Allergy Center, in Finland, advising patients with asthma, parents and the physicians to pay close attention to the findings from this survey.

With better patient education [and] increased communication between physicians, parents and patients, we can rectify some of the issues raised, she added.

The survey was conducted by Harris Interactive on behalf of the GAAP Survey Advisory board via online and telephone interviews in May/August 2005.

2nd September 2008


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