The adolescent with asthma in Primary Care

Objectives: To asses the prevalence of asthma in our children, is grade, follow up and management by the paediatrician. 979 clinic histories are reviewed finding 45 adolescents between 10 and 14 years of age with the diagnosis of asthma. Results: The cumulated prevalence of asthma was 4.6%, male to female ratio 1.6:1. Age of onset 4.8±3 years, age at diagnosis 7.9±3 years. Atopic familiar antecedents in 35.6% and personal antecedents 75,6%, pneumonia 17,8%, ORL illness 40.0%, bronchiolitis 6,7%, gastro-oesofageal reflux 2.2% and igA deficiency 8.3%. Neumoallergens sensitivity 84,6% (84,8% gramineae pollens). Exercise induced asthma 31,0%. 62,2% were classified as mild asthma, 37.8% as moderate and none as severe. At 8 years of age 20% of children are asinthomatic, 48.9% had a better situation, 20% stayed equal and only 11.1% had worsened: 71.1% were being managed by the specialist in Allergology, 28.9% by the paediatrician of Primary Care. Only 21.6% of children had undergone function test and 504% had home PEM control. Among the children still under control at present nearly 11.1% were treated with oral bronchodilators, 60.9% were under or had been under inmunotherapy, 80.4% were under maintaining therapy (56.7% inhaled corticosteroids, 40.5% cromones, 24.3% long duration inhaled beta-agonists and 24.3% oral ketotifen). Conclusions: There is a similar prevalence of asthma compared to other studies, it is preponderant in our environment the sensitivity to gramineae pollens. We are worried about the poor implication of Primary Care in the follow up of these patients as well as the scarce realisation of functional test.