Medical care of asthma and wheezing illness in children: a community survey

Abstract

A survey was carried out to investigate the medical care of asthma and wheezing illness in a school population. Children with current wheezing illness were identified by a screening questionnaire to the parents of 5100 children in one school cohort from all schools in an outer London borough. Of the 89% who responded, 11.1% reported wheezing within the past 12 months. Parents of a sample of 284 wheezy children aged about 9 were interviewed at home about their child's illness and the related use of drugs and services. There was evidence of substantial underuse of services and this was not associated with social, family, or general practice factors. Considerable proportions of children were not having drug treatment, were receiving only non-antiasthmatic drugs, or were using antiasthmatic drugs incorrectly. The most important social and family factor associated with undertreatment was poor maternal mental health, and this factor appeared to explain the observed association of manual social class with undertreatment. Only about half of the most severe group were labelled as having "asthma," and those with this label were more likely to be receiving treatment and using outpatient services. The results show that the potential of modern treatment to prevent disability due to wheezing illness is not being realised despite the existence of a free and accessible health service.