Persistence and Remission in Childhood Asthma

Abstract

The concentration of health services use within 1 year following the initial diagnosis of childhood asthma points to the need for attentive follow-up and ongoing management and education strategies in the early years.

Declines With Age in Childhood Asthma Symptoms and Health Care Use

“…This study demonstrates that among African American and white children declines in childhood asthma symptom frequency and asthma-related health care use in ages from 2 to 15 years must be accounted for in the evaluation of intervention effects. The findings are in agreement with those reported in the literature (Koh & Irving, 2007; Martin et al, 1980; Piippo-Savolainen & Korppi, 2008; Sears et al, 2003; To et al, 2007; Vonk et al, 2004). The new contribution of this study is the proposed ALSE method that enables adjustment for the natural decline not accounted for in a pre–post study by borrowing data from existing control cohorts.…”

Loss of control in preschoolers with asthma is a risk factor for disease persistency

“…Atopic comorbidity at inclusion, such as allergic rhinitis, eczema and food allergy, showed a trend of association with persistent asthma. This result is coherent with several other studies, showing that atopic disease is closely linked with asthma and asthma persistency in younger children 14,16,26 . Finally, we found that birth by caesarean section also showed a trend of association with asthma persistency at the end of follow‐up.…”

“…In our study approximately half of the children had remission of their asthma during follow‐up, which is consistent with other studies among young children 8,14 . Our study showed that experiencing any loss of control event throughout the 3 years of follow‐up and when restricted to the first year was a significant risk factors for persistence of asthma.…”

“…Our study showed that experiencing any loss of control event throughout the 3 years of follow‐up and when restricted to the first year was a significant risk factors for persistence of asthma. This observation is coherent with a population‐based birth cohort study by To et al 14 showing that having an asthma‐related hospitalisation the year following the diagnosis was an independent predictor of asthma persistency in children diagnosed with asthma under the age of 6. Further, we found that any acute loss of control event defined as either visit to the ED, hospital admission or oral corticosteroid course throughout follow‐up as well as during the first half of follow‐up was significant risk factors for persistent asthma.…”

“…Further, we found that any acute loss of control event defined as either visit to the ED, hospital admission or oral corticosteroid course throughout follow‐up as well as during the first half of follow‐up was significant risk factors for persistent asthma. These results are in line with other studies, where an increased amount of asthma‐related physician visits, hospitalisation and treatment at the hospital have been linked to persistency of asthma 14–16 . However, while Csonka et al and Amat et al based their definition of persistency on a questionnaire and To et al on a heterogenous register‐based cohort, this study was based on objective measures.…”