Under the active participation of high-profile representatives of all parties concerned (policymakers —European Parliament and Commission—, patients, healthcare
professionals and academia), a highly constructive debate took place which resulted
in a number of recommendations. Assessment of current practices in asthma
treatment across Europe reveals flaws:
• Although the scientific knowledge about
asthma and its optimal treatment has
increased tremendously during the last
twenty years, this knowledge has not
been adequately reflected in the day-today
actions of those seeing patients. This
is particularly the case in community
settings.
• Asthma is not seen as a systemic
disease beyond the lungs. As a result,
patients are inadequately diagnosed—
possible allergies, such as allergic rhinitis,
are not taken into account. Also, rather
than considering alternative “controller”
medications, the doses of inhaled
steroids prescribed to the patient are
simply increased. This can be linked
to increase the risk of side-effects,
particularly in children.
• Worse, especially in paediatric asthma,
there has been a noticeable increase in
the use of ‘off-label’ medicines, i.e. the
prescription of medicine in a different
dose, or for a different medical indication
than it is licensed for.
• Furthermore, not even the multiple
guidelines on asthma treatment offer
adequate support and guidance for
patients and healthcare professionals.
Patients feel inadequately informed
about the existence of innovative
treatment options and are concerned
about the lack of investment in research
in this area.
.The time to act is now: On 24 January
2006, Liz Lynne MEP—together with the
International Primary Care Respiratory Group
(IPCRG)—hosted a policy roundtable in the
European Parliament in Brussels to assess the
main deficiencies in current asthma treatment
across Europe, as well as to discuss EU policy
options to ensure adequate doctor and patient
information, empowering them to make an
informed choice.
Any parent who has sat through the night watching a child gasp for air knows that even mild asthma causes great suffering. Parents watch helplessly as their child's lungs constrict and each new breath seems to be drawn up a narrow straw. The child's panic rises, the heart races, and breathing becomes an increasing struggle.
In the United Kingdom, an average of 30 people is killed by asthma each week, and more than five million patients are undergoing treatment at any time. Children appear to be particularly vulnerable, and compared with 25 years ago, there has been a six fold increase in the number of cases. The disease is reaching epidemic proportions. One in seven children in the United Kingdom are afflicted, and in the United States, over nine million children have developed the life-threatening condition. Theories abound about the causes of asthma--it has been linked to obesity, poor housing, breast milk, junk food, pet ownership, and indoor air quality, to name but a few suspects.
The U.K. government and the European Commission now appear to be taking seriously the results of a U.S. study that claims to have demonstrated, for the first time, that children exposed to ozone are more likely to develop the disease.
Researchers compared new asthma cases in 3,535 children from 12 Southern Californian communities that were monitored over five years. Six areas had relatively good air quality, while the other half suffered some of the worst smog episodes in America. The study also focused on children who played a lot of outdoor sports, such as football, basketball, and baseball, which required them to breathe in up to 17 times more air when they exerted themselves.
Out of the sample group, 265 children were diagnosed as suffering from asthma during the study. Children exerting themselves in the polluted cities were found to be three times more likely to develop the disease.
"This research suggests that, contrary to conventional wisdom, ozone is involved in the causation of asthma," explained lead author Rob McConnell, associate professor of preventive medicine at the University of Southern California. "Somewhat to our surprise, in low-ozone communities we found no increased risk of asthma in children who played team sports."
Professor McConnell added that other risk factors, such as family income, smoking habits, pest infestations, and history of allergies had all been controlled in the study.
A year before, scientists at the University of California-Davis had found that rhesus monkeys who had been breathing ozone for five months developed symptoms similar to those of a child with borderline asthma, Professor Charles Popper, who led that research team, had previously found that ozone did not cause the same level of lung damage in adult monkeys.
Following publication of last month's findings, U.K. Environment Minister Michael Meacher announced that he would refer the research to the official committee on the medical effects of air pollution for further investigation. European Union Environment Minister Margot Wallstrom has called for a review of pollution levels in member states, as a result of the research, and has declared that children's health will go to the top of the commission's agenda.
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