MONDAY, March 16 (HealthDay News) -- Better medications have improved asthma control in children since the mid-1990s, but too many children are not receiving optimum asthma care even if they have insurance, according to research presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held March 13 to 17 in Washington, D.C.
In one study, Joseph Spahn, M.D., of National Jewish Health in Denver, and colleagues compared National Jewish Health Day Program charts of 65 children treated in 2004-2007 and 164 children treated in 1993-1997. Compared to the historic cohort, they found that the current cohort was less likely to require chronic oral glucocorticoid therapy than the historic cohort (28 percent versus 51 percent), that most of the current cohort was receiving leukotriene receptor antagonists or a combination of inhaled glucocorticoids and long-acting bronchodilators (76 percent and 66 percent, respectively, versus 0 percent), and that the current cohort had a higher mean forced expiratory volume in one second (84 versus 76).
In a second study, Tracy L. Kruzick, M.D., also of National Jewish Health in Denver, and colleagues studied 153 children (mean age 9.3), 89 percent of whom had medical insurance. They found that both insured and uninsured children had high rates of prednisone use (30 percent and 47 percent, respectively), hospitalization (39 percent and 53 percent, respectively), emergency care (56 percent and 67 percent, respectively), uncontrolled daytime (30 percent and 27 percent, respectively) and nighttime symptoms (32 percent and 20 percent, respectively) and a low rate of inhaled corticosteroid use (26 percent and 17 percent, respectively).
"Despite coverage and accessibility to health providers, there were still high percentages of students with uncontrolled asthma and that did not use inhaled corticosteroids, illustrating the need for programs that can identify and monitor children at risk for high asthma morbidity," Kruzick and colleagues conclude.