Clinical: Managing asthma in children

Diagnosing asthma in children is challenging due to the lack of definitive tests for those under five. Common indicators include recurrent coughing or wheezing (especially at night), chest pain, and a history of related conditions like eczema or family respiratory issues. Management focuses on minimizing symptoms through preventer and reliever medications, aiming for a life free of nighttime waking, rescue inhaler use, or activity limitations.

Treatment begins with a trial of preventer inhalers or leukotriene receptor antagonist tablets. A key component of clinical success is verifying inhaler technique with a spacer and ensuring patient adherence. If symptoms remain controlled for three months, dosage should be evaluated for reduction. Additionally, healthcare providers should assist families in identifying personal triggers and managing seasonal sensitivities, such as hay fever.

Effective asthma care relies on a strong partnership between clinicians and families. Providing a personalised written asthma action plan is critical, as it has been shown to significantly reduce hospitalizations. Clinicians should encourage parents to monitor symptoms for patterns, address misconceptions regarding the side effects of inhaled steroids, and provide clear guidance on how to manage emergency attacks, ensuring prompt action and consistent follow-up care.