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Asthma in kids and teens: New research from CSC's Dr. Jean-Marie Bruzzese holds promise for improved treatment and care

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Asthma remains the most common chronic illness in children and adolescents. Its potentially debilitating and even life-threatening symptoms can be reduced if asthma is managed properly by young people and their caregivers, making good research on how to accomplish those goals especially urgent.

The Child Study Center's Dr. Jean-Marie Bruzzese led two new studies on asthma in youth, the results of which were published in spring 2011. Her findings hold great promise for improvements in care and treatment for children afflicted with this illness and their families.

In the first study, Dr. Bruzzese and her colleagues found that teaching adolescents techniques for managing their asthma, in both group and individual sessions conducted at their schools, coupled with further education for the teens' medical providers, helped teens have fewer symptoms, better quality of life and avoid the need for emergency care.

The 8-week intervention, which Dr. Bruzzese called Asthma Self-Management for Adolescents (ASMA), targeted African American and Hispanic inner city youth, who have higher rates of asthma and hospitalizations due to asthma. The program seeks to take advantage of teens' increasing independence and cognitive development in teaching them to take responsibility for their own day-to-day care. The program was also designed to leverage teens' desire for peer support, through the group sessions, while still addressing individual differences in asthma symptoms. Lastly, it spoke to a need identified by the researchers to increase medical providers' knowledge of the most up-to-date asthma treatment practices and recommendations by providing them with education and consultation from asthma specialists.

Teens who participated in ASMA experienced important improvements including taking more steps to prevent symptoms before they occur, fewer interruptions of sleep, fewer days of reduced activity, fewer emergency department visits and fewer hospitalizations. Dr. Bruzzese's findings were published in the American Journal of Respiratory and Critical Care Medicine.

In the second study, published in Pediatric Allergy, Immunology and Pulmonology, Dr. Bruzzese and her colleagues developed questionnaires to assess asthma-related anxiety in children and their parents, a potentially critical factor in successfully treating asthma. Among adults with asthma, it's been shown that asthma-related anxiety can have a negative impact on successful treatment, contributing to disproportionate reactions to symptoms and over-medicating.
 
Before Dr. Bruzzese's study, there was no scientifically valid way to measure asthma-related anxiety in youth with asthma and their caregivers. The instruments the researchers created, which they dubbed the Youth Asthma-related Anxiety Scale (YAAS) and the Parent Asthma-related Anxiety Scale (PAAS), pointed to two key factors—anxiety about the severity of the illness, and anxiety over associated restrictions in activity—as good overall indicators of both the presence and degree of anxiety regarding asthma.

"This will be a valuable tool for asthma researchers," says Harold Farber, MD, MSPH, editor of Pediatric Allergy, Immunology, and Pulmonology, and associate professor of pediatric pulmonology at Baylor College of Medicine. "Now that we have validated measures for asthma-related anxiety in children and their parents, future research will be able to measure the impact of asthma-related anxiety on asthma outcomes. This will help us better understand how to deliver the best asthma care for our children."