Difficult asthma is defined as poorly controlled asthma. In this category patients experience chronic symptoms, punctuated by exacerbations of asthma plus a continued requirement for short-acting (reliever) inhalers despite a high daily dosage of steroids for 6 months or longer. To test the validity of the diagnosis and treatment for 'difficult asthma' researchers in Belgium investigated sixty children diagnosed with the condition. Their study took the children away from their home environment and placed them in a low allergen residential setting for between 3 and 8 months depending upon the child. During the study period doctors monitored the children's symptoms and their reliance upon medication. They found that by removing the children from adverse environmental or social factors a health gain could be achieved. The adverse factors included, passive smoke, non-compliance of medication, exposure to common asthma triggers and personal stress.
Benefits from the study? There is an urgent need to identify and reduce the cost of asthma on society as a whole. In India, the monthly cost of drugs for one asthmatic child can amount to one third of the family's monthly income. In the United States reports indicate that childhood asthma results in 14 million missed days off school each year, and in the UK (during 2002) over twenty eight thousand asthmatic children were admitted to hospital because of the disease and cost the country's taxpayers a whopping 2.3 billion that year. Much of this cost came from patients diagnosed with 'difficult asthma'.