Most young asthmatics retain good lung function after switch to adult healthcare
MedWire News: Adolescents with asthma are unlikely to experience any deterioration in lung function as a consequence of switching from pediatric to adult healthcare, research shows.
Writing in the journal Respiratory Medicine, Sten-Erik Bergström (Karolinska University Hospital, Stockholm, Sweden) and colleagues explain: “There is presently some concern that childhood asthma may persist and/or deteriorate later in life.
“Even though the transfer from pediatric to adult healthcare and simultaneous changes in lifestyle during the critical late adolescent period is of extreme importance in this connection, the influence of these factors on adolescents with asthma has been little studied.”
To address this, the team studied 150 adolescents (65 females), aged an average of 17.7 years at baseline, with asthma who were being transferred from pediatric to adult healthcare. Those with mild-to-moderate asthma (n=97), defined as a FEV1 of more than 80% of the predicted value, were randomly assigned to primary care or specialized care at an adult asthma clinic.
All the participants underwent pulmonary function, bronchial responsiveness, working capacity, and skin prick tests at baseline and up to 5 years later.
Analysis revealed that, overall, mean FEV1 values increased during the 5-year study period whereas mean FEV1/forced vital capacity ratios remained unchanged.
The percentage of patients with bronchial hyper-responsiveness fell over the study period, from 71% at baseline to 59% after 5 years. Poor adherence to asthma medications was associated with persistent bronchial hyper-responsiveness, while regular exercise was associated with a reduced risk for the condition.
The researchers also found that, although mean working capacity decreased over the study period, it was not associated with changes in lung function, oxygen uptake, atopy, gender, or other factors.
No significant changes in responses to the skin prick tests were observed during the 5-year study period.
Bergström and team conclude: “The present investigation indicates that, despite persistent bronchial hyper-responsiveness, increasing body mass index and a decline in working capacity after leaving the pediatric asthma clinic, the majority of adolescents with asthma demonstrate good lung function.”
They add: “Poor adherence to asthma management was the only factor associated with an increased risk for persistent bronchial hyper-responsiveness 5 years after the transfer to adult healthcare, suggesting that the follow-ups required by young adults with mild/moderate asthma well can be provided effectively by the primary healthcare system.”
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By Mark Cowen