Overview of asthma management in children 1–5 years

Overall goals for the Australian population:

• to minimise asthma deaths
• to minimise ED visits for asthma
• to minimise the burden of disease due to asthma.

Overall goals for individual patients:

• to minimise symptoms and disruption to sleep, play and preschool
• to minimise exacerbations requiring urgent care and systemic corticosteroids
• to achieve and maintain healthy lung function
• to minimise adverse effects of asthma treatment
• to avoid unnecessary medication by recognising spontaneous remission of asthma if it occurs.

Management of preschool asthma is based on:

• establishing and rechecking the diagnosis as necessary
• assessing symptom control and risk factors repeatedly over time
• choosing treatment suitable for the child’s pattern of symptoms, history of exacerbations and risk factors
• providing information, skills and tools for parents and carers to manage a child’s asthma, including:
  – training in correct inhaler technique
  – information and support to maximise adherence to prescribed medicines
  – an individualised written asthma action plan
  – information about avoiding triggers, where appropriate
• reviewing and adjusting treatment periodically
• managing exacerbations when they occur
• managing comorbid conditions that affect asthma or contribute to respiratory symptoms, such as allergic rhinitis
• providing advice about trigger exposure, healthy eating, physical activity, healthy weight and immunisation.

Asthma treatment in children 1–5 is based on inhaled medication:

• rapid-acting bronchodilators to manage symptoms (all children)
• ICS to reduce airway inflammation and prevent exacerbations (when indicated).