FCAAIA Notes: It is encouraging that asthma is a less common cause of school absence and hospitalization than it was, but that doesn’t necessarily mean overall asthma control is that much better. Maybe we are treating more aggressively and earlier to avoid the necessity of hospitalization and thus getting children back to school sooner.
One of the best ways to avoid asthma exacerbations is to maintain the best possible control BETWEEN flares. Far too often, I see children and adults with asthma who think they are fine on a day-to-day basis but have frequent symptoms, poor sleep, exercise intolerance, and low lung function. Bodies are smart; they accommodate to symptoms so there is not tremendous impact on quality of life at these low grade baseline symptoms. However, once the baseline control improves, patients finally recognize that they didn’t feel so great after all. Then it is also easier to recognize and intervene early when symptoms worsen, thus avoiding ER visits, hospitalizations, and absenteeism.
Is your asthma as well controlled as you think? Come in to see us—let’s make sure
(Source: https://www.medpagetoday.com/pediatrics/asthma/71001?xid=nl_mpt_DHE_2018-02-08&eun=g1127101d0r&pos=1&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-08&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days Feb. 8, 2018)
Children with asthma in the United States are having fewer asthma attacks and also missing less school due to the airway disease, according to a new report from the CDC which suggests significant improvement in pediatric asthma control.
The percentage of hospitalizations among kids with asthma declined by more than half, from 9.6% in 2003 to 4.7% in 2013, according to the report “Vital Signs: Asthma in Children — United States, 2001-2016,” published Tuesday in Morbidity and Mortality Weekly Report.
In 2013, children with asthma missed, on average, 2.6 days per child due to asthma attacks, compared with 4.2 days in 2003 and 3.3 days in 2008.
The percentage of children experiencing one or more asthma attacks during the previous year declined from 61.7% in 2001 to 53.7% in 2016.
Roughly six million kids and teens have asthma, and asthma prevalence has grown in recent years. Asthma is the most common chronic disease of childhood.
“Overall, there are some encouraging trends,” CDC acting director Anne Schuchat, MD, said in a press briefing.
“Clinicians, families, communities, and schools have contributed to great progress in teaching children how to recognize asthma attacks early and how to respond to them,” she said.
Schuchat noted that more kids with asthma and their parents are now receiving personalized asthma action plans to help them recognize the signs and symptoms of an asthma attack and the proper response. These action plans are often shared with schools and other caregivers.
But she noted that not all of the news is good.
Despite the progress, one in six children with asthma still visits hospital emergency departments or urgent care centers each year for asthma attacks and one in 20 is hospitalized. More than half of children with asthma in the U.S. had one or more attacks in 2016.
The asthma rate among black children in the U.S. remains more than double that of white children, and living in poverty remains a significant risk factor for asthma.
Earlier this week CDC reported that 53 children in the U.S. have died of influenza so far in a worse-than-normal flu season, and Schuchat noted that asthma is the most common comorbid condition among children who have been hospitalized for the flu.
CDC researchers examined data from the National Health Interview Survey for children between the ages of 0 and 17 to explore asthma trends and demographic differences in asthma outcomes and health care utilization. Among the findings:
- Asthma was more prevalent among boys (9.2%) than among girls (7.4%) and among children age 5 and over (approximately 10%) than younger children (3.8%)
- Asthma was more prevalent among non-Hispanic black children (15.7%) and children of Puerto Rican descent (12.9%) than among non-Hispanic white children (7.1%), and among children living in low-income families (10.5%) than among those living in families with income ≥250% of the Federal Poverty Level (approximately 7%)
- Asthma prevalence among children increased from 8.7% in 2001 to 9.4% in 2010, and then decreased to 8.3% in 2016
- The slight decline in prevalence in 2016 was seen in all groups studied, except Mexican and Mexican-American children. In these children, asthma prevalence increased from 5.1% in 2001 to 6.5% in 2016.
Although asthma prevalence was lower among young children, younger children (age 0-4) had a higher prevalence of asthma attacks than older children (age 12-17) (6.2.4% versus 44.8%), as well as emergency department or urgent care center visits (31.1% versus 9.6%) and hospitalizations (10.4% versus 2.8%).
While not all changes were statistically significant, a similar pattern was observed among all demographic groups studied, with the exception of Mexican/Mexican-American children, whose asthma prevalence increased from 5.1% in 2001 to 6.5% in 2016.
Cathy Bailey, PhD, of the CDC Division of Environmental Hazards and Health Effects, noted that CDC is working with state, local, private, and non-government partners to support good medical management, but she added that parents have a big part to play by reducing triggers in the home such as secondhand smoke and pet dander and making sure children are on appropriate medications.
The report found that just over half (54.4%) of children with asthma who were taking asthma control medications took them regularly as prescribed.
Bradley Chipps, MD, president of the American College of Allergy, Asthma and Immunology, said the finding of a decline in asthma attacks and hospitalizations confirms what allergists are seeing.
He told MedPage Today that hospitalizations are now rare among children and adults who are under the care of an allergist and who are taking their medications as prescribed.
Chipps noted that when he started practicing medicine 30 years ago, he would have three or four patients with asthma in the hospital at the same time.
“Today it is really rare, because we are able to get their asthma under control,” he said.