Parents' beliefs impact kids' asthma control

NEW YORK (Reuters Health) - Asthma control in over one in three children with asthma is not as good as it could be, and in many cases the suboptimal control relates to potentially modifiable beliefs of the parents, new research suggests.

In a study of 754 children between 2 and 12 years old with persistent asthma, 280, or 27 percent, had "suboptimal control" of their asthma. Nearly half of the children with suboptimal control underused controller medication.

In telephone interviews with the parents who these children, Dr. Tracy Lieu, from Harvard Medical School, Boston, and colleagues found that parental beliefs seem to play an important role in asthma control.

Specifically, they found that children were more likely to have troublesome asthma symptoms if their parents had low expectations for how well their asthma could be controlled. They were also more likely to have poorly controlled symptoms if there was no set time or routine for taking asthma medication.

Concerns about other family issues and lack of parental knowledge about asthma were also related to worse asthma control.

It is recommended that children with persistent asthma use asthma control medication daily. Yet some parents, the researchers found, mistakenly thought asthma is an intermittent rather than chronic condition, that two days of symptoms per week is adequate control, and that medication use is needed only when their child had symptoms or not at all.

"Our findings suggest that parents' expectations and perceptions are key factors influencing how well their children's asthma is controlled, and how effectively they use medications," Lieu, the study's senior researcher, noted in a written statement.

"Interventions to improve asthma control and to increase appropriate controller medication use, especially among vulnerable populations, should include specific strategies ... to identify and to address the modifiable factors identified in this study," the investigators conclude in a report in the journal Pediatrics.

"Such interventions have the potential to improve asthma care and outcomes generally and to address persistent disparities in asthma morbidity," they add.

SOURCE: Pediatrics, October 2008.