MINI-SYMPOSIUM: THE BURDEN OF ASTHMAThe burden of asthma in children: a European perspective
Section snippets
INTRODUCTION
Depending on disease characteristics, such as prevalence, natural course and disease control, the burden of a disease can have a major impact on the patient, their family and society.
Bronchial asthma is a major cause of morbidity in children in developed countries. Over recent decades, a large number of epidemiological studies investigating the prevalence of childhood asthma have documented an increase in prevalence.1 Asthma affects about 8.6 million children in the USA.2 In Westernised
BURDEN OF ASTHMA – DIFFICULT TO DEFINE
It is impossible to develop a single estimate for the ‘burden’ of asthma.5 Several surrogate single parameters have been used in order to quantify the burden of asthma, such as data on prevalence, severity, lung function, general practitioner and hospital attendances, treatment regimens, morbidity and mortality, quality of life, limitations in normal life, direct/indirect costs and a few other asthma-related measures. However, these parameters only address the burden in regard to some limited
PARAMETERS IN THE ASSESSMENT OF THE BURDEN ON THE PATIENT
Derived from recently published surveys on disease burden, a number of different parameters may be used to assess the impact of asthma on those who have it, as follows:
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number of asthma-symptom days;
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number of night-time awakenings;
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number of asthma attacks;
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number of emergency department visits/urgent physician visits;
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number of hospitalisations;
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use of quick-relief medicines/rescue medication;
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number of oral prednisone courses;
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number of prescriptions;
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number of missed days from school;
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effect on
PARAMETERS IN THE ASSESSMENT OF THE BURDEN ON THE FAMILY
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Missed work of adult caretakers – due to the child's asthma.
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Effect on quality of life of siblings, parents and caretakers.
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Effect on lifestyle and activity of siblings, parents and caretakers.
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Consequences on professional career of parents and/or caretakers.
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Direct expenditures for medical care and medical costs.
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Indirect costs arising from morbidity and mortality including the value of time lost from work by parents/caretakers.
Again, this list nicely reflects the urgent need for an overall
PARAMETERS IN THE ASSESSMENT OF THE BURDEN ON SOCIETY
Healthcare costs arising from asthma may be the major burden on society. Socio-economic factors are integral to asthma care. However, they do not only affect society but also the patient and their family. There are other important factors, such as the patient's absence or his or her physical or psychological limitations, which not only have a major impact on the patient and/or their family but also on group dynamics in school activities and in extracurricular activities and hence on society.
HOW TO REDUCE THE BURDEN OF ASTHMA
It could be expected that by understanding and reducing the factors contributing to the burden of asthma, the overall burden, as well as the specific burden on the patient, their family and society, could be greatly reduced.
The prevalence of asthma varies worldwide, most likely due to different genetic backgrounds as well as different exposure to various risk factors such as respiratory infections, indoor/outdoor pollution and diet. Understanding the interaction of risk factors and genetic
CONCLUSION
Childhood asthma exerts a tremendous burden on patients, families, caretakers, society and healthcare providers. Recognising the sizeable disease burden should establish asthma as a priority area in national healthcare strategy. A better understanding of aetiology, pathogenesis, risk factors and protective influences for asthma development may improve primary, secondary and tertiary preventive measures. Improved individual targeting of existing therapies and facilitating the development of
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Understanding the economic burden of asthma
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(2001)Global Strategy for Asthma Management and Prevention
Prevalence of Asthma
(2002)- American Lung Association. Prevalence Based and Revised National Health Interview Survey. Data and Statistics. November...
Global Strategy for Asthma Management and Prevention
Natural History of Asthma
(2002)Global Strategy for Asthma Management and Prevention
Mortality and Morbidity
(2002)Global Strategy for Asthma Management and Prevention
Burden of Asthma
(2002)
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