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Using Music and Sports to Improve Kids' Asthma
Date:3/16/2009

More consistent medication use, fewer ER visits result, studies find,,

MONDAY, March 16 (HealthDay News) -- The singular appeal of music and sports can be successfully harnessed to deliver health information to young children and teens coping with asthma, while also encouraging them to stick more closely to the treatments prescribed for their condition, a pair of new studies suggests.

One study explored giving teens regular access to popular music, via digital music players, and mixing in audio messages about asthma authored by the teens themselves. The result: Kids exposed to the music-message combo were much more likely to take their medications.

And a second study found that the amount of time young children ended up seeking asthma treatment from either a doctor or a hospital emergency room dropped in the months after they participated in a day-long asthma education camp that had been coupled with basketball lessons.

"Ours was a very small proof-of-concept study, but the kids loved being in it -- which is very important -- and we've gotten really good results," said the lead author of the music study, Dr. Giselle S. Mosnaim, an assistant professor in the department of immunology/microbiology at Rush University Medical Center in Chicago.

"We improved asthma controller adherence to above the clinically important 70 percent mark, up from 39 percent before we began," Mosnaim noted. "And we maintained it above 70 percent for the entire study. So this is very exciting."

Mosnaim was expected to present the findings -- as were researchers from Allegheny General Hospital in Pittsburgh, who did the sports study -- at the annual meeting in Washington, D.C., this week of the American Academy of Allergy, Asthma & Immunology.

"If teens take their controllers every day, asthma is a controllable disease," Mosnaim said. Daily use of inhaled anti-inflammatory steroids can prevent the kind of inflammation that compromises breathing, even in the absence of active symptoms.

"The medication helps them avoid having shortness of breath, wheezing or nighttime awakenings, and helps them avoid having to go to the ER and the hospital," she said. "But, unfortunately, there are all sorts of reasons kids don't take their medication. Things as simple as, 'Oh, I forgot,' to the social stigma associated with taking them, such as the idea that if you have asthma, you can't play sports -- which is not true."

The sports study enrolled 21 boys and girls, 6 to 12 years old, in a one-day camp. All had asthma diagnoses and, during camp, all were exposed to comprehensive asthma information workshops as well as basketball skills training.

Although no change was observed in terms of the frequency with which the children used their oral steroid medications, follow-up surveys two and four months later revealed fewer physician visits and a trend toward decreased use of hospital emergency rooms.

In the music study, Mosnaim and her colleagues assembled a group of three boys and one girl, 12 to 18 years old and all from inner city, low-income, African-American families. All the youths had been diagnosed with moderate but persistent asthma and had a history of repeated ER visits for asthma treatment.

The kids were asked to form a makeshift musical group, tasked with devising beat-box and vocal percussion-driven asthma informational messages for their own consumption. The audio messages were then incorporated into a play-list of popular music tracks on iPod Shuffles, which would play the music and messages in no predictable or controllable order.

After eight weeks of routine listening to their iPods --coupled with twice daily phone calls to remind the youths to take their medications -- Mosnaim's team found that the group's general knowledge of asthma had improved, and their drug compliance had rocketed to more than 70 percent.

At 70 percent compliance and above, she said, clinical improvement is expected to take place.

"These were just regular kids with asthma and a history of hospitalization, and this program really made a difference for them," Mosnaim noted, adding that they are planning a larger and longer study along the same lines.

Dr. Jonathan Field, director of the allergy and asthma clinic at the New York University School of Medicine/Bellevue Medical Center in New York City, expressed enthusiasm for the findings.

"The studies are small," he noted, "and there remains the question of how long the effects will last, so I would love to see larger studies, with different age groups, that look at whether or not there is a waning impact over time. But, clearly, I think that anything you can do with sports or music to enhance medication compliance is very important."

"I think these are great ideas, because they seem tailored to provide positive reinforcement that would probably appeal to most kids," Field said. "And they could probably be applied to a lot of different situations, not just asthma."

More information

The American Academy of Allergy, Asthma & Immunology has more on asthma and children.



SOURCES: Giselle S. Mosnaim, M.D., assistant professor, department of immunology/microbiology, Rush University Medical Center, Chicago; Jonathan Field, M.D., director, allergy and asthma clinic, New York University School of Medicine/Bellevue Medical Center, New York City; American Academy of Allergy, Asthma & Immunology 2009 annual meeting, Washington D.C., March 13-17, 2009


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