Education And Debate


BMJ 1995; 310 doi: (Published 10 June 1995) Cite this as: BMJ 1995;310:1522
  1. John Rees,
  2. John Price

    The aims of treatment should be:

    • to abolish symptoms and allow children to lead a full and active life at home and at school

    • to restore normal lung function

    • to minimise the requirement for relief medication

    • to enable normal growth and development and avoid adverse effects of medication.

    These can be achieved by prompt diagnosis, identification of trigger factors, evaluation of severity, establishment of a partnership of management with the asthmatic child and the family, and regular review.

    Partnership in management

    Assessment of management

    • Frequency of cough/wheeze

    • Use of relief medication

    • Days off school/activity

    • Inhaler technique

    • Understanding of treatment

    There has been much discussion recently about “self management” and “self management plans.” The term is slightly misleading and a better description is partnership in management. The aim is to develop a strategy for management which will help asthmatic children and their families to cope with the day to day care of their asthma. The strategy should be adapted to the severity of the asthma and to the home and school circumstances. Partnership in management comprises:

    • understanding asthma and its treatment

    • monitoring symptoms

    • if the child is old enough, use of a peak flow meter,

    • an agreed action plan of what to do if the asthma improves, gets worse or the child has an acute asthma attack

    • written guidelines.

    Trained respiratory nurses working in asthma clinics and in schools have a vital role in partnership management. There are also many educational aids available including written material produced by lay organisations such as the National Asthma Campaign, videos, computer programs, and so on. They are valuable supplements to but not substitutes for regular personal contact between families and appropriately trained healthcare professionals.

    Changing the environment

    The avoidance of cigarette smoke is important. Families with asthmatic children should be encouraged not to acquire pets. Pets have to go when allergy has been …

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