Asthma management with adolescents

Treating asthma requires adherence to an ongoing treatment plan, regular monitoring, adjustments in the plan as needed and self-care. Some studies have shown that asthma management creates a particular set of challenges among adolescents, who are seeking greater autonomy, developing socially and emotionally, and experiencing changes in their relationships with friends and family.

The task of managing a chronic medical condition or taking medication in front of peers may cause embarrassment or self-consciousness. The routine may seem like a burden to greater independence, or there may be denial about the severity of asthma. Adolescents with asthma may be at greater risk of depression and anxiety, and these psychological factors may result in poorer asthma management.

Your child's doctor may address these concerns with several strategies, including the following:

• Assessing for symptoms of depression or anxiety
• Assessing for risk-taking behaviors
• Assessing for proper technique in using medications
• Talking with your child about his or her understanding of the disease and the impact of the medication
• Talking with your child about how he or she feels about taking medication, especially in front of people
• Working with the family to create a plan that gradually shifts more responsibility to your child

Create an action plan

Your doctor can work with you and your adolescent to create a written action plan that outlines self-monitoring and care. You should share the plan with other family members, friends, teachers, coaches and school administrators. A thorough plan includes such things as the following:

• Your child's name and age
• Physician and emergency contact information
• The type, dose and timing of long-term medications
• The type and dose of rescue medication
• A list of common asthma triggers for your child and tips for avoiding them
• A system for rating normal breathing and moderate symptoms and severe symptoms
• Instructions for what to do when symptoms occur and when to use rescue medication
• Instructions for when to seek emergency care

Monitor and record

Your doctor will likely ask your child to use a peak flow meter at home. This hand-held device measures how well air flows from the lungs when exhaling. It can monitor the effectiveness of your ongoing treatment and assess lung function after using a rescue medication.

You can work with your adolescent to keep a record of peak flow measurements, symptoms and treatment schedule to share with your doctor. These records can help your doctor determine if the long-term treatment plan is effective and make adjustments to the plan. Keep appointments as recommended by your doctor to review records and adjust the action plan as necessary.

Information that should be recorded includes:

• Regular, non-attack peak flow measurements as requested by your doctor
• The time, duration and circumstances of an asthma attack
• Treatment responses to asthma attacks, including peak flow measurements
• Peak flow measurements after exercise
• Medication side effects
• Changes in symptoms
• Changes in sleep patterns

Control asthma triggers

Depending on the triggers for your child's asthma, make adjustments as much as possible at home, school and other environments to minimize your child's exposure to triggers. These may include:

• Cleaning thoroughly to control dust and pet dander
• Checking pollen count reports
• Removing cleaning products or other household products that may be an irritant
• Using allergy medicine as directed by your child's doctor
• Helping your child develop a strategy for avoiding triggers