Diagnosis and management of asthma in preschool and school-age children: focus on the 2007 NAEPP Guidelines

Abstract

This review examines the changes in the revised National Asthma Education and Prevention Program (NAEPP) Guidelines for the diagnosis and management of asthma pertaining to children and highlights areas that may benefit from further study. The most recent NAEPP Guidelines contain several pediatric-specific features, including subdividing classification and treatment recommendations, into three age categories (0-4 years, 5-11 years, and >or=12 years). The introduction of the concept of two domains within asthma severity and control, namely impairment and risk, allows classification of patients who are either treatment-naive (asthma severity) or who are receiving controller therapy (asthma control). Suggestions for criteria for initiating daily controller therapy in preschool children with exacerbations or risk factors for asthma symptom persistence, including the asthma predictive index, are discussed. Evidence-based treatment recommendations are provided for the three age groups. The recent NAEPP Asthma Guidelines improve on many areas of the diagnosis and treatment of asthma in children and lead to the identification of areas that would benefit from further research.