 "Getting parents to accept a diagnosis of asthma; teaching them to administer medication; convincing them that kids really do need to take medications on a daily basis; and persuading them to stop smoking, are the important challenges in treating children with asthma."
-Dermot Ryan RESPONSES BY SUBJECT
 Are there any special problems in diagnosing asthma in children? Do they vary by age?
What do you think are the special issues and challenges in treating children with asthma? Do they vary by age?
What questions do parents/carers and patients ask of you?
Which educational strategies work?
Which in your opinion are the top three problems children and parents/carers face in managing asthma in daily life?
RESPONSES BY COUNTRY
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Responses by countryDermot Ryan (UK):
Are there any special problems in diagnosing asthma in children? Do they vary by age?The big problem is the diagnosis in kids under the age of 3 because of the more likely diagnosis of viral-induced wheeze, which seems to be a different sort of disease. The situation is generally clearer in older children: the history is easier to obtain, the children themselves can often contribute more to the history, especially pertaining to when the parent is not around. Serial peak flow measurements and reversibility can be assessed from about the age of 5; these are useful adjuncts in making the diagnosis. Clearly, in all situations, we inquire about family history and personal history of atopy. If a child has a personal history of atopy or a strong family history, particularly a maternal history, of atopy, they are more likely to have asthma.What do you think are the special issues and challenges in treating children with asthma? Do they vary by age?Getting parents to accept a diagnosis of asthma; the administration of the medication; convincing them that kids really do need to take their medication virtually all the time; getting the parents to stop smoking.What questions do parents/carers and patients ask of you?What shouldn't they do? Should they miss school? How often should they take their medication? Will they need it for life? What do I do when it gets worse? Are there any side effects of any of the medications?Which educational strategies work?Telling the patients about what the disease is and what the medications are for. Telling them that the important thing is that by taking the medications, they can control the disease and lead a completely normal life. So I think stressing the normality of asthma rather than the downside, stressing the importance equally of taking the medication on a regular basis in order to control the problem. We seem to get through to the vast majority of patients. But different people want to hear different things, so you really have to adapt and change according to the individual's needs, individual circumstances.Which in your opinion are the top three problems children and parents/carers face in managing asthma in daily life?
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