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Uncontrolled Asthma Leads to Missed School, Work

Lack of consistent medicine use likely important cause, experts say,,,,

TUESDAY, Oct. 23 (HealthDay News) -- People with poorly controlled asthma are more than twice as likely to miss school or work than those whose symptoms are well-managed, researchers say.

Youngsters with uncontrolled asthma missed more than six school days in a six-month period compared to just 2.6 missed school days for their healthier peers, a new study found, and adults with poorly controlled asthma missed almost five days of work versus 1.5 days for their counterparts with well-controlled airway symptoms.

"I wasn't surprised to see there was a difference in absenteeism, but I was a little surprised at the magnitude of the difference. The real goal of this paper was to get people focused on control," said the study's lead author, Dr. David Tinkelman, a professor of pediatrics and vice president for health initiatives at National Jewish Medical and Research Center in Denver.

The problem, explained Tinkelman, is that asthma is one of the few chronic diseases where you can sometimes miss your medications without suffering immediate ill effects. In contrast, if someone with diabetes doesn't take their insulin, they'll start to feel sick very quickly. But, if it's summer and there aren't many asthma triggers present, someone might be able to forgo their asthma controller medication for a little while without feeling terribly ill. Unfortunately, that lack of medication will eventually catch up with the asthmatic, Tinkelman said.

"Asthma medications can be hard to take on a regular basis, but if you want to prevent asthmatic episodes from keeping you from work or your child out of school, it's important to take controller medications daily," said Tinkelman.

There are two types of medication available to treat asthma: fast-acting "rescue" medications, such as albuterol inhalers that immediately start to relieve symptoms; and preventive "controller" medications, such as corticosteroid inhalers and the leukotriene antagonist medication montelukast (Singulair) that help reduce inflammation and may keep symptoms from starting.

The study, which was expected to be presented Oct. 23 at the American College of Chest Physicians' annual meeting, in Chicago, included more than 13,000 people with asthma from across the United States who were surveyed by phone.

When the researchers compared those with well-controlled asthma to those who were experiencing asthma symptoms, they found that children with uncontrolled asthma missed 145 percent more school days on average, and adults with poorly controlled asthma symptoms missed 208 percent more work days.

Researchers from National Jewish Medical and Research Center, Wyeth Pharmaceutical Research and Cerner LifeSciences were involved in this study.

"Asthma is a chronic illness that requires surveillance," said Dr. David Nash, clinical director of the Asthma Center at Children's Hospital of Pittsburgh. "In between asthma exacerbations, especially in children, people may feel good, and they may forget to take their medications. But, if you can set up an asthma regimen that's as easy as possible to follow, kids shouldn't miss school, and adults shouldn't miss work. We can make asthma a very controllable disease," said Nash.

According to Tinkelman, primary care physicians need to be aware that when they see a patient once every six months or once a year, that patient may not remember that they missed school or work a couple of months ago because of their asthma. That means that physicians really need to question patients to make sure they're maintaining good asthma control.

"If we can get people on their medications and work hard on controlling environmental measures, such as secondhand smoke and allergy triggers, I think the vast majority of asthmatics will do much better," said Nash.

More information

To learn more about controlling asthma, read this information from the Nemours Foundation.

SOURCES: David Tinkelman, M.D., professor, pediatrics and vice president, health initiatives, National Jewish Medical and Research Center, Denver; David Nash, M.D., clinical director, Asthma Center, Children's Hospital of Pittsburgh; Oct. 23, 2007, presentation, annual meeting, American College of Chest Physicians, Chicago

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