‘Difficult Asthma’: Can Symptoms be Controlled in a Structured Environment?

摘要: Objective Difficult asthma implies persistent symptoms despite therapy with high doses of inhaled corticosteroids. The objective was to evaluate children difficult in a setting that excludes aggravating factors such as poor treatment adherence and adverse environmental influences. Patients Methods Sixty (≥6 years) had been referred because the rehabilitation centre over period 10 years. diagnosis symptom control confirmed if exacerbations continued during stay or interfered daily activities at least 3 times week. Results The median 5 months. In four patients other than made. five remained difficult. remaining 51 children, became well controlled. Many contributed home setting: (n = 32), parental smoking (n = 22), allergen exposure (n = 10). Psychosocial problems occurred 36 children. Contributing often co-existed. During centre, lung function improved group controlled (P < 0.001) but not control. majority who obtained good control, this persisted years following discharge. Conclusion Of 60 asthma, optimal medical management structured environment resulted patients; patients, made 4 patients. Pediatr Pulmonol. 2009; 44:743–748. © 2009 Wiley-Liss, Inc.