Asthma control level in asthmatic children followed in general practice medicine in France: results of ER'ASTHME study

Little information is available on asthma control level in children in France in general practice medicine although such control is I of the essential goals of treatment. The ER'Asthme survey has been set up to assess asthma control among asthmatic patients visiting their general practitioner and to determine the clinical and therapeutic associated factors. Methods. - Cross-sectional ancillary study carried out in 1410 asthmatic children aged 6 to 14 years old (B/G 65/35%), with asthma diagnosed at least 12 months earlier and visiting spontaneously their GP. It collected data on self-assessed health status, asthma control (assessed by 3-level composite score based on the Canadian consensus criteria as adapted by Anaes: optimal, acceptable and unacceptable), and compliance (PMAQ3w questionnaire) during the last 4 weeks. Results. - Children (or their parents) answered the question about their asthma control as follow: 62% << excellent >> or << fine >>, 31% << not very good >> and 7% << poor >>. GPs, however, assessed asthma control as optimal in 27% of children, acceptable in 7% and unacceptable in 66%. Eighty-four per cent of children had taken a maintenance treatment. Only 57% of patients reported complete compliance with their maintenance treatment (60% in 6-12 years old vs 52% in 13-14 years old, P = 0.0089). Asthma control level was significantly associated to the asthma severity (P = 0.0063), type of maintenance treatment (P < 0.0001) and to treatment compliance (P = 0.0005). Conclusion. - Asthmatic children aged 6 to 14 years old (or their parents) overestimate their asthma control, which remains inadequate. Severity of asthma, compliance level and the type of maintenance treatment influence the level of asthma control. (c) 2007 Elsevier Masson SAS. Tous droits reserves.