How to manage a child with difficult asthma?
File(s)
Author(s)
Saglani, S
Fleming, L
Type
Journal Article
Abstract
Introduction: Children with difficult asthma have significant morbidity and fail to achieve asthma control despite being prescribed high dose maintenance treatment. If control remains poor after diagnostic confirmation, detailed assessments of the reasons for asthma being difficult-to-control are needed. Underlying modifiable factors including non-adherence to medication, persistent environmental exposures that trigger asthma symptoms and psychosocial factors contribute to poor control in these patients.
Areas covered: The focus of this review is to provide a practical approach to the diagnosis and management of difficult asthma including an overview of long term assessments to identify potential progression to true, severe asthma. A multi-disciplinary team is critical to enable modifiable factors to be identified and addressed. Significant resources are required to manage paediatric difficult asthma optimally and only specialist centres should be tasked with the assessment of these patients. Although this may have an impact on healthcare resources, long term benefits for lung health are significant.
Expert commentary: The management of paediatric difficult asthma is not simple and involves numerous professionals with varied expertise. However, if it is not undertaken with the appropriate skills, there is a significant risk of children receiving inappropriate invasive investigations and therapies that will have no impact on morbidity.
Areas covered: The focus of this review is to provide a practical approach to the diagnosis and management of difficult asthma including an overview of long term assessments to identify potential progression to true, severe asthma. A multi-disciplinary team is critical to enable modifiable factors to be identified and addressed. Significant resources are required to manage paediatric difficult asthma optimally and only specialist centres should be tasked with the assessment of these patients. Although this may have an impact on healthcare resources, long term benefits for lung health are significant.
Expert commentary: The management of paediatric difficult asthma is not simple and involves numerous professionals with varied expertise. However, if it is not undertaken with the appropriate skills, there is a significant risk of children receiving inappropriate invasive investigations and therapies that will have no impact on morbidity.
Date Issued
2016-06-02
Date Acceptance
2016-05-12
Citation
Expert Review of Respiratory Medicine, 2016, 10 (8), pp.873-879
ISSN
1747-6348
Publisher
Taylor and Francis
Start Page
873
End Page
879
Journal / Book Title
Expert Review of Respiratory Medicine
Volume
10
Issue
8
Copyright Statement
© 2016 Taylor & Francis. This is an Author's Accepted Manuscript of an article published in Expert Review of Respiratory Medicine, Volume 10, Issue 8, available online at: http://www.tandfonline.com/10.1080/17476348.2016.1191355.
Sponsor
National Institute for Health Research
European Respiratory Society
Grant Number
CDF-2014-07-019
n/a
Subjects
Paediatric
diagnosis
difficult asthma
management
problematic severe asthma
severe asthma
Respiratory System
Public Health And Health Services
Publication Status
Published