Management of Asthmatic Adolescents

Elers J, Backer V. Management of Asthmatic Adolescents.  Annals of Respiratory Medicine, February 2010; 1(1):61-68

Review Article

Jimmi Elers and Vibeke Backer
Affiliations: Respiratory and Allergy Research Unit, Bispebjerg Hospital

ABSTRACT

This review explores issues in the diagnosis and management of asthmatic adolescents. Asthma is the most common chronic disease in childhood/adolescence. Uncontrolled asthma impairs quality of life, reduces attendance in school, sport, and physical activities, and results in enormous economic health costs. Many asthmatic adolescents accept considerable asthma symptoms as being part of their disease, and are not aware of the degree of control that is possible. Low adherence to prescribed controller medications is a common problem because of concern about side‐effects. Smoking status must be considered in asthmatic adolescents. Proper inhalation technique must be viewed. Physician‐related factors include lack of knowledge of the etiology of asthma, insufficient communication, and underestimate of the prevalence of asthma, and/or overestimate of asthma control, resulting in inadequate prescription of controller medication. In order to improve asthma management, useful international guidelines have been developed. National Heart, Lung, and Blood Institute (NHLBI), British Thoracic Society (BTS), and Global Initiative for Asthma (GINA) guidelines, updated in 2008, provide physicians with a useful tool to manage asthma in adolescents in order to gain asthma control over time. Correct diagnosis, identifying comorbidities in asthmatic adolescents, and regular assessment of asthma control are essential to good management. Patients, parents, and physician must know what well‐controlled asthma looks like. Asthma management includes several therapy modalities: asthma education, environmental control, and pharmacotherapy. Implementation of the international guidelines by physicians treating adolescents with asthma is fundamental to reduce the incidence of uncontrolled asthma. The purpose of the current review is to assist physicians in improving asthma control among their adolescent patients.

Keywords: Asthma, adolescents, management, treatment, control, monitoring
Correspondence: Jimmi Elers, Respiratory and Allergy Research Unit, Bispebjerg Hospital, Bispebjerg bakke 23, DK‐2400 København NV, Denmark. Tel: (45)‐35313569; Fax: (45)‐35312179; e‐mail: jele0004@bbh.regionh.dk