What’s in a name?: Children treated with asthma medications without the diagnosis

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There is considerable underdiagnosis of asthma in childhood. Stempel et al at the University of Washington investigated the medical and pharmacy claims data of 295,099 American children during 2001 and identified 12,994 who had been treated for asthma without the diagnosis being coded and 19,879 who received the diagnosis.

Compared to controls and asthma cases, the treated but not diagnosed children looked a lot like asthma—they received prescriptions for steroids at a rate 7-fold greater than controls and experienced a higher rate of emergency department visits, hospitalizations, and health expenditure.

The authors concluded that underdiagnosis of asthma continues to be a problem and accounts for significant pediatric morbidity with high levels of medical expenditure. Asthma, by any other name such as reactive airways, pneumonia or wheezy bronchitis, has only negative associations: lack of diagnostic clarity and under-treatment!

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