title: Monitoring asthma in childhood: management-related issues.
abstract: Management-related issues are an important aspect of monitoring asthma in children in clinical practice. This review summarises the literature on practical aspects of monitoring including adherence to treatment, inhalation technique, ongoing exposure to allergens and irritants, comorbid conditions and side-effects of treatment, as agreed by the European Respiratory Society Task Force on Monitoring Asthma in Childhood. The evidence indicates that it is important to discuss adherence to treatment in a non-confrontational way at every clinic visit, and take into account a patient's illness and medication beliefs. All task force members teach inhalation techniques at least twice when introducing a new inhalation device and then at least annually. Exposure to second-hand tobacco smoke, combustion-derived air pollutants, house dust mites, fungal spores, pollens and pet dander deserve regular attention during follow-up according to most task force members. In addition, allergic rhinitis should be considered as a cause for poor asthma control. Task force members do not screen for gastro-oesophageal reflux and food allergy. Height and weight are generally measured at least annually to identify individuals who are susceptible to adrenal suppression and to calculate body mass index, even though causality between obesity and asthma has not been established. In cases of poor asthma control, before stepping up treatment the above aspects of monitoring deserve closer attention.
authors.affiliation: Dept of Pediatric Pulmonology and Allergology, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Bart L
authors.initials: BL
authors.lastname: Rottier
authors.affiliation: Respiratory and Allergic Disease Division, Dept of Paediatrics and Adolescence Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Ernst
authors.initials: E
authors.lastname: Eber
authors.affiliation: Dept of Women's and Children's Health and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden Astrid Lindgren Children's Hospital, Stockholm, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Hedlin
authors.affiliation: Dept of Paediatrics, University of Aberdeen, Aberdeen, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Turner
authors.affiliation: Royal Alexandra Children's Hospital, Brighton, UK.
authors.forename: Edwina
authors.initials: E
authors.lastname: Wooler
authors.affiliation: Dept of Paediatrics, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Eva
authors.initials: E
authors.lastname: Mantzourani
authors.affiliation: Leicestershire Partnership Trust and Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
authors.forename: Neeta
authors.initials: N
authors.lastname: Kulkarni
mesh_terms: D000280:Administration, Inhalation; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003661:Decision Support Techniques; D018450:Disease Progression; D004777:Environment; D006801:Humans; D007223:Infant; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D055118:Medication Adherence; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents