23 Jul 2005
IPCRG seeks to address concerns that current guidelines and treatments do not adequately meet patient needs in asthma -
Experts from the International Primary Care Respiratory Group (IPCRG) today called for a greater focus on the paediatric management of asthma in order to improve outcomes and quality of life for children across Europe. Paediatric asthma has increased by 200 percent over a 20 year period from the mid 1970s to the mid 1990s and is still on the rise.1 Ten percent of European children suffer from asthma symptoms. This rate is reported to be up to ten times higher in Western Europe than in Eastern Europe.2 Inadequate control of asthma symptoms in children results in unacceptable symptom burden and impacts on quality of life.
The European Commission (EC) recently announced their new proposal for regulation on medicines for children, which aims to ensure that medicines are meeting children's therapeutic needs. The EC reported that over 50 percent of medicines used to treat children have not been tested and authorised for use in children - their use is often based on data extrapolated from adults.3
In fact, current management approaches do not sufficiently recognise differences between paediatric asthma and adult asthma - there are differences in the pattern severity of disease and children respond differently to medications.
In order to address these issues, the IPCRG has applied to the EU for a grant to develop an asthma assessment instrument specifically for children. If approved, this initiative will be the first of its kind in children, it will identify children whose asthma is not being adequately controlled, gather relevant information and in doing so, facilitate improved paediatric management. Above all, this approach will recognise that children cannot be simply treated as adults.
Furthermore, the IPCRG is also proposing that the assessment instrument be developed for use in children using a similar tool already developed and tested in adults. The project would involve piloting the new management tool in three EU/EEA member states and assessing the potential long-term impact of a change in paediatric asthma management with a view to extending the use of the instrument throughout Europe.
"The IPCRG feels that the issues surrounding paediatric asthma management have been left unquestioned for too long and therefore decided to take action through the application of an EU grant. We hope that this new instrument will identify factors affecting asthma management in paediatric patients. For example, the instrument will help us to explore whether current treatment approaches and guidelines are appropriate for children" said project co-ordinator, David Price, University of Aberdeen.
Exploring the multi-factorial nature of asthma in adults
Uncontrolled asthma is not an issue that is unique to children. The current reliance on symptoms and lung function (an assessment of how efficiently a person is inhaling and exhaling air) to measure control is insufficient, and does not recognise that asthma is a multi-factorial disease - priority should be given to controlling airway inflammation.
To address this concern the IPCRG has applied for a separate EU grant in the area of adult asthma management. This second application aims to address a gap in asthma surveillance and response by developing a simple and usable instrument which will allow physicians to provide patients with individualised feedback on how their asthma can be better managed. In addition, the tool will also act as a database for the collation of information relating to the multi-factorial nature of asthma. Using this tool, the IPCRG hope to initiate a pilot programme within member states, to demonstrate how it can drive improvements in asthma control and quality of life.
"We need to take a critical look at whether the reliance on symptoms and lung function as a measure for asthma leads to an over-reliance on certain treatments, such as beta-agonists, which could be a critical issue affecting patient care. We hope these applications will be the first step to achieving this," concluded David Price.
For further information on the grant applications, the IPCRG or asthma or to interview a spokesperson please contact:
Tel: +44 (0) 207 413 3080
- WHO data
- Report 'Children's health and environment: a review of evidence', produced by the European Environment Agency and WHO's Regional Office for Europe
- EU Regulation on Paediatric Medicines. Medicines and Healthcare products Regulatory Agency (MHRA)