• J R Meurer, C P Helstad, S M Wiegmann, K J Kelly, R Fisher, D Bukstein, and P Wegehaupt.
• Community Pediatrics Center, Advancement of Urban Children, Medical College of Wisconsin and Children's Health System, USA.
• WMJ. 2001 Jan 1;100(8):26-34.

ProblemAsthma management should follow evidence-based national guidelines. We compared patient self-reports of usual care to clinical practice guidelines.MethodsCross-sectional survey of parents of 245 children age 2-14 years with asthma seen by physicians at 13 practices in Wisconsin.ResultsMost children with asthma were atopic and a substantial number experienced psychosocial problems. Families infrequently used written care plans. Knowledge about asthma triggers, especially tobacco smoke, was deficient. Increasing asthma severity was associated with poorer health. Although most parents rated their physician's expertise as excellent or very good, one-third of children with persistent symptoms used no daily control medication. Significant differences were observed between primary care and specialty care with the best asthma self-management done by patients of specialists.ConclusionCare of Wisconsin children with asthma inconsistently follows national guidelines. They and their families require improved education, written care plans, appropriate medications, and psychosocial support.

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