November 5, 2014
Breathlessness Causes Obese Children to Overuse
Asthma Medications  

Orlando—When obese children with asthma become breathless, they too often incorrectly assume their disease is out of control and unnecessarily use rescue medications, according to a new study.

The research found that overweight/obese children with early-onset asthma display poorer asthma control and a distinct pattern of symptoms. Compared to lean children, the larger patients were more likely to have shortness of breath instead of cough as their primary asthma symptom and to self-medicate with short-acting beta-agonist (SABA) medications three times as often, according to the study published online in the Journal of Allergy and Clinical Immunology.

“Obese children with asthma need to develop a greater understanding of the distinct feeling of breathlessness in order to avoid not just unnecessary medication use, but also the anxiety, reduced quality of life and health care utilization that come along with this misunderstood symptom,” said lead researcher Jason Lang, MD, MPH, of the Division of Pulmonary Medicine at Nemours Children's Hospital in Orlando, FL “Alleviating this overuse of rescue medications could likely also lessen other symptoms obese children with asthma are impacted by, including most notably acid reflux.”

For the research, the lung function, usage of medications, symptom patterns, healthcare utilization, quality of life and caregiver perceptions of asthma-related quality of life in children with body mass index (BMI) equal to or greater than the 85th percentile were compared to children with BMI in the 20th to 65th percentile. Overall, 58 children between the ages of 10 and 17 participated in the study’s three clinical visits.

In addition to reporting shortness of breath more often than cough, the obese children had more gastrointestinal symptoms as measured by GERD score and lower asthma-related quality of life.

Study authors suggest that the sensation of breathlessness in the obese children with early-onset, allergic asthma could be related to heightened airflow perception and GERD symptoms. In addition, greater use of SABA has been shown to reduce esophageal sphincter tone, thereby creating a cycle of GERD, chest symptoms and more SABA use.

Weight loss or other alternative self-management plans are recommended to improve GERD, asthma-related symptoms and medication utilization, according to the researchers.

“This research helps define how overweight and obesity affect the patterns and severity of asthma symptoms in children,” said Lang. “We hope to use this information to improve self-management and health care utilization for this critical patient population.”

U.S. Pharmacist Social Connect