Asthma control in London secondary school children

ABSTRACT

Objective: The asthma control test (ACT) is a validated tool for assessing control in asthmatic children aged 12 years and older. Using the ACT, we sought to assess asthma control and knowledge in London secondary school children. Methods: Secondary schools in London, UK, participated in this study. Children with doctor-diagnosed asthma were invited to complete an online questionnaire that included the ACT and questions about asthma. Suboptimal asthma control was defined as an ACT score of ≤ 19 out of a maximum score of 25. Data are summarised as median and interquartile range (IQR), and were analysed by either Mann-Whitney test, or chi-square test. A p value of < 0.05 was considered significant. Results: A total of 799 children completed the questionnaire; 689 (86.2%) were included for analysis. Suboptimal asthma control was reported by 49.6% of students. Over a third (42.4%) of students prescribed a short-acting β2-agonist inhaler felt uncomfortable using it at school, and 29.2% (n = 173) reported not using this inhaler when wheezy. 56.4% (n = 220) of those with regular inhaled corticosteroids did not take them as prescribed, and 41.7% did not know what this inhaler was for. Suboptimal control was associated with a greater proportion of students reporting that they were ‘somewhat’, ‘hardly’ or ‘not at all’ comfortable using inhalers at school (52.7% vs 29.1%, p < 0.01) and outside school (22.8% vs. 14.8%, p < 0.01). Conclusions: Suboptimal asthma control and poor asthma knowledge are common in London schoolchildren.

KEYWORDS:

• Paediatrics
• treatment

Acknowledgements

This project has been gifted the license to use the Asthma Control Test™ by GlaxoSmithKline, an industry partner of NIHR CLAHRC: North Thames. Thanks to Amanda Begley, at GlaxoSmithKline, and all the participants and teachers at the schools involved in this project for their continued support. Thanks to the Centre of the Cell Youth Membership Scheme and schools network and UCLPartners Schools Health and Well-being Research Network. Thanks to Professor Chris Griffiths for his continued support with this project.

Declaration of interest

JG was the principal investigator for the study, and planned and provided overall supervision to the rest of the team. KH contributed to the planning of the study, carried out the data collection, conducted the data analysis and wrote the final manuscript. GM contributed to the planning of the study and carried out the data collection, and contributed to the final manuscript. RR contributed to the planning of the study, and contributed to the final manuscript. AW participated in the planning of the study, and contributed to the final manuscript. SAW developed the data collection tool, contributed to the planning of the study, assisted on some data collection and contributed to the final manuscript.

Funding

This study was funded by the National Institute for Health Research; North Thames Collaboration for Leadership in Applied Health Research and Care.This study presents independent research funded by the National Institute for Health Research Collaboration Leadership in Applied Health Research and Care (NIHR CLAHRC) North Thames at Bart's Health NHS Trust. The views expressed are those of the author(s) and are not necessarily those of the NHS, the NIHR or the Department of Health.