ASTHMA SOCIETY OF IRELAND ASKS ‘IS IRELAND ASTHMA SAFE FOR CHILDREN?’

WORLD ASTHMA DAY, TUESDAY, 3RD MAY 2022 - The Asthma Society of Ireland today released findings of a survey of Irish parents or guardians/carers about their children’s asthma.  One in ten children in Ireland have asthma[1]. 73% of parents/carers surveyed reported that they have experienced anxiety around managing their child's asthma – and 28% indicated they experienced this anxiety ‘always or often’.

This anxiety is just not just limited to parents or carers. The Asthma Society’s survey also shows the level of anxiety in children about their asthma. Parents’ reports suggest 2014% of children worry always or often about having an attack in public (, the same number20% of children worry always or often about having to take their medication in public) and 22% worry always or often about participating in sports, in case it triggers their asthma.[2]

Access to Medication

In total, the survey reported that just over a quarter (26%) of parents struggled with the cost of their child’s asthma medications.

5% said they have forgone buying their child’s asthma medications as they couldn’t afford the medication or device; 5% had forgone buying their child’s medication because they could not afford to pay for the cost of a new prescription. A further 16% of parents/guardians reported having had to forgo other essential items in order to purchase their children’s asthma medications. 

Rationing or forgoing asthma medication can lead to serious exacerbation of symptoms such as coughing, wheezing and breathlessness, and, indeed, can escalate to a dangerous asthma attack.  The Asthma Society has been calling for the inclusion of asthma medications on the Long-term Illness Scheme since its the organisation’s inception in 1973, but successive governments have refused to update the Scheme. The Scheme has not been updated in 52 years. The government must, at a minimum, fulfil its commitment to review the Scheme under the Sláintecare Implementation Strategy, including conducting a public consultation on the matter.

Delayed Treatment of Children with Asthma due to COVID-19

The impact and uncertainty caused by COVID-19 has also been of real concern for those caring for children with asthma.  19% of respondents reported avoiding or delaying going to hospital for their child’s asthma due to fears of them contracting COVID-19.

Almost 59% of respondents reported being unsure whether their child’s symptoms were caused by asthma or COVID-19. As a result, almost 16% reported that this uncertainty resulted in a delay in appropriate treatment for the child. 

Parents also reflected the challenges of COVID-19 for children with asthma as including the symptoms of COVID-19 and asthma being similar, very frequent testing for COVID-19, the lack of understanding that coughing or shortness of breath, and many school days being lost unnecessarily as a result.

Is Ireland an ‘Asthma-Safe Country’ for Children?

Analysing the results coming through in the survey, the Asthma Society is posing an important and pressing public health question – is Ireland an ‘asthma-safe country’ for children?

     One in ten children in Ireland have asthma and one in five will develop it at some point in their childhood. There are a number of factors that are key to making Ireland an ‘asthma-safe country’ for children – timely access to appropriate healthcare, affordable asthma medication, support for parents and children to learn more about the illness and to build self-management skills, awareness of the 5 Step Rule (to manage an asthma attack) across children, parents and broader society, and the provision of Asthma Action Plans for every child with asthma.

Sarah O’Connor, CEO of the Asthma Society of Ireland commented,      “When we looked at the survey results, they really do speak volumes about Ireland’s status as an “asthma safe” country for children. In a year when the paediatric Model of Care for asthma is being developed by the HSE, we believe it is imperative to note that Ireland is not currently an ‘asthma-safe country’ for children.”

“We are very worried that parents report being forced to choose between everyday essentials and their children’s medication. The rising cost of living will, no doubt, force parents to make more difficult decisions unless the cost of asthma medicine is sufficiently tackled.  The survey also indicates that COVID-19 has affected access to healthcare for children with asthma. This combination leaves parents and children with a very unsafe scenario in terms of asthma management.”

“The Asthma Society will present further insights from the survey to Minister Josepha Madigan in a meeting next week to discuss asthma management in creches and schools. It is critical that childhood asthma is taken seriously as a condition and that prevailing misconceptions that put children’s lives at risk are addressed. Schools and creches are very important locations - our children need them to be ‘asthma-safe’ for our society to be ‘asthma-safe’.”

CEO, Sarah O’Connor, continued: “One parent commented in their survey response: “A child with asthma already knows the “fear” of being unable to catch their breath     ”. Reading that gave me such pause about the impact of COVID-19 on children with asthma. Woven into the responses of parents in this survey, and those who use our services      is the universal experience that children with asthma in Ireland have had a very difficult time since the pandemic started. This has not been a short-term development for their health and it is ongoing. We must restore children’s confidence in their health and wellbeing, give them and their parents or carers the tools to manage their asthma, ensure they have access to medications and health services as needed, and make asthma acceptable in the eyes of their peers. This is no small undertaking, but it is crucial to ensure Ireland’s respiratory patients are going to be able to manage their own illness. The data provided through this survey will be informing our work for some time to come.”

Access to Healthcare

In addition, 23% of parents or carers surveyed had had (at least one) emergency room visit to manage their child’s asthma in the last year. 25% of those waiting for a referral to a consultant were waiting over three years, indicating that access to healthcare is an issue, and an additional 20% were waiting one to three years. Of the respondents’ children, 3% experienced asthma attacks more than once a week, 2% once a week, 5% once a month and 36% every few months – all an indication that asthma may not be controlled.

Dr Dermot Nolan, GP with a special interest in respiratory medicine, and former Asthma Lead for the ICGP said, “It is important that parents, carers, educators and sports coaches are informed about a child’s day-to-day asthma management, an Asthma Action Plan is in place and that all carers know how to help in the case of an asthma emergency.

One in five (21%) of those surveyed did not know, or were not sure, of the symptoms of an asthma attack. Almost a third (32%) had not heard of or were unsure of the 5 Step Rule to manage an asthma attack. Only over a half (57%) actually knew the steps involved in the 5 Step Rule. Parents, carers, teachers, SNAs, and the general public need this information available to them, at their fingertips if Ireland is to be ‘asthma-safe’ for each and every child.

It is important to remember that one person still dies every five days from asthma in Ireland[1] so it is crucial that patients take medications as prescribed and seek medical attention within 24 hours of an asthma attack. I was concerned about the survey findings that showed that 37% of children were not seen within 24 hours of having an asthma attack by a healthcare professional. Our children need a healthcare system that can guarantee timely access to care to manage a respiratory emergency.

If you are unsure about your child’s  asthma, your GP can help you form an Asthma Action Plan.  The Asthma Society offers great support to families through their Asthma Adviceline and WhatsApp messaging services. The Society also provides a range of instructional videos to share with family and friends and resources that can be posted on your fridge, for example.”

Asthma and Allergies in Children Webinar, Thursday 5th May

The Asthma Society is urging the Irish public, as part of Asthma Awareness Week 2022, to attend their upcoming Asthma and Allergies in Children Webinar this Thursday, 5th May from 7-8 pm.  Aimed at parents and carers of children with asthma this is a free informational event that will feature Dr Muhammad Tariq, a Consultant Paediatrician speaking about how allergy affects asthma control in children and the role of immunotherapy.  Dr Tariq will be joined by Lisa Egan, a Respiratory Advanced Nurse Practitioner who will share practical tips on managing your child's asthma, best practice inhaler techniques and how to create an Asthma Action Plan. 

You can sign up for the webinar on asthma.ie or via - https://us02web.zoom.us/webinar/register/WN_Y3_C2yiIS0iZH7CYc6_F5A

Asthma Adviceline and WhatsApp Messaging Service

If parents have concerns, they can contact the Asthma Adviceline for a nurse appointment by calling 1800 44 54 64 or the Sláintecare funded, Beating Breathlessness WhatsApp messaging service 086 059 0132, which allows patients with asthma and COPD, and their family and carers, to message a respiratory specialist nurse about all aspects of their disease management.

380,000 people in Ireland live with asthma, with 890,000 likely to develop the condition at some point in their lifetimes.[2]  To support the Asthma Society’s crucial work and help the Society to continue to offer its patient support services, we ask that you donate today via asthma.ie/donate.

References:

[1] Easing the Economic Burden of Asthma: The Impact of a Universal Self-Management Programme, Asthma Society of Ireland, June 2019.

[2] Survey conducted by the Asthma Society of Ireland of 433 parents/carers between 22nd - 29th April 2022.