Book Reviews

Asthma is a frightening and sometimes life-threatening disease. Control Your Child's Asthma is a well-organized book to be read and referenced by anyone--parent, health care practitioner, or other justifiably concerned person, such as a teacher with asthmatic students--who wishes to be as knowledgeable as possible in the art of managing and controlling childhood asthma from infancy through adolescence.

Control Your Child's Asthma has many pertinent, up-to-date bibliographic references. This feature should give the book high priority over most other similar works on an asthma-related reading list and is especially important for locating other authoritative sources of knowledge useful to those who care for asthmatic children. At the same time, however, this level of detail may limit the breadth of readership because the book does require a certain level of experience and education to be fully appreciated.

As is clearly indicated on the cover in boldface red letters, the book is about controlling (not curing) asthma. The road map to achieving or maintaining this control--as well as recapturing lost control--is beautifully, clearly, and (in most areas) simply laid out for the reader, and the book appropriately assigns a high degree of importance to a key aspect of good asthma control: finding a knowledgeable, competent health care practitioner and establishing an alliance with that person. Unfortunately, however, the book does not sufficiently emphasize the important fact that a cure for asthma does not exist, either at present or in the foreseeable future. This point should be presented more prominently because some parents who believe otherwise may be inclined to seek this mythical cure relentlessly and in ways detrimental to the child.

As good as this book is, future editions could make a few areas even better. I would point out that QVAR^® is mentioned early in Chapter 7 but is missing from the drug table on the last page of the chapter. Moreover, the book does not overtly mention what has become the clarion call of asthma control: the "Rule of 2's." This topic would fit nicely (preferably highlighted in boldface type) under the existing heading, "Staying in the Green Zone."^1:108 The lengthy discussion on theophylline therapy could be replaced by a brief notation, eg, "This drug is rarely used today for asthma therapy."

I would also point out that "mild intermittent" asthma^1:108 is not a class of asthma severity recognized by the NHLBI Guidelines of 1997,² even though most experts would agree that children can have a mild, moderate, or severe degree of intermittent asthma. In addition, a brief reference to taking zafirlukast with food to enhance absorption^1:73 is contrary to the actual recommendation.^3,4

Perhaps more encouragement would be given to parents and health care providers if, on page 57, mention were made of the newer, higher-potency inhaled corticosteroids, which provide more rapid onset of action (one to three days, in many cases).

The book's format makes liberal use of tinted boxes to emphasize important points, but I believe this technique could have been used even more. For example, greater visual emphasis would be useful in the section discussing inhaled corticosteroid use and its effect on growth (ie, a neutral effect, in most cases),^5-7 because this issue arises repeatedly in practice. I would also advocate more liberal use of boldface type to highlight headings or key issues, eg, "Staying in the Green Zone";^1:108 and in the chapter on "Complementary and Alternative Treatments"; to the sentence ("None of these approaches can fully substitute for asthma medications"^1:186) I would add "or avoidance of triggers."

All in all, this first edition of Control Your Child's Asthma is a superb book for educating persons who are genuinely interested in understanding more about this common, complex, and all-too-often distressing syndrome of childhood.

References

1. Farber HJ, Boyette M. Control your child's asthma: a breakthrough program for the treatment and management of childhood asthma. New York: Henry Holt; 2001.
2. National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. [Bethesda, MD:] National Institutes of Health, National Heart, Lung, and Blood Institute; 1997. (NIH Publication No. 97-4051.)
3. JAMA Asthma Information Center. Treatment Center. Asthma Drugs. Accolate [Web site]. Available on the World Wide Web (accessed October 17, 2001): www.ama-assn.org/special/asthma/treatmnt/drug/accolate.htm.
4. MEDLINEplus Health Information. Zafirlukast (Systemic) [Web site]. Available on the World Wide Web (accessed October 17, 2001): www.nlm.nih.gov/medlineplus/druginfo/zafirlukastsystemic202917.html.
5. Brand PL, Hendriks JJ, Vaessen-Verberne AA. [Inhalation of corticosteroids and the growth of asthmatic children] [article in Dutch]. Ned Tijdschr Geneeskd 1999 Oct 9;143(41):2041-5.
6. Turktas I, Ozkaya O, Bostanci I, et al. Safety of inhaled corticosteroid therapy in young children with asthma. Am Allergy Asthma Immunol 2001 Jun;86(6):649-54.
7. Pedersen S. Assessing the effect of intranasal steroids on growth. J Allergy Clin Immunol 2001 Jul;108(1 Suppl):S40-4.

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