Inhaled steroids linked to improved school performance in asthma

Researchers from Greece say that the use of steroid inhalers in elementary school children with asthma may improve school performance over other forms of therapy.

Writing in BioMed Research International, the team suggests this could be due to the prevention of the exaggerated absenteeism observed among children with the disease.

“Administration of inhaled corticosteroids, the most effective therapy for asthma treatment, may reduce and control asthma symptoms leading to lower school absenteeism and consequently to improved school attendance and performance,” comment Emmanouil Paraskakis (Democritus University of Thrace) and colleagues.

They studied data on 1539 students aged 8 to 16 years, 262 (17.0%) of whom had asthma.

Over a 2-year period, children with asthma were absent significantly more often than children without at a mean of 6.2 days versus 0.3 days. The authors found that this absenteeism was associated with asthma severity and also correlated with healthcare use.

They also report that in elementary school, children with asthma were 36% less likely to perform “excellently” according to parental reports than those without (43.3 vs 59.0%).

Additionally, excellent performance was reported by teachers more often for those without asthma at 42.2% compared with 33.3% of those with asthma, and grade point promotion indicated excellent performance for 85.6% of children without asthma and 79.2% of children with asthma.

Interestingly, elementary school students with asthma who received inhaled corticosteroids were 4.3 times more likely to have excellent performance in the previous 2 academic years than those who did not receive steroids, at 81.2% compared with only 50.0%.

Analyses showed that absenteeism was associated with poor school performance and, in elementary school students, with lower grade point promotion. Additionally, parental education was significantly associated with school performance both in students with and without asthma.

Paraskakis and colleagues say that the use of inhaled steroids likely “affects asthma control level and consequently the learning process and… school performance.”

Furthermore, they add that their finding of an association between parental education level with absenteeism and school performance is something that should be taken into account in future studies of the association between asthma and educational outcomes.

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