The study, led by researchers from the Department of Ambulatory Care and Prevention at Harvard Medical School and Harvard Pilgrim Health Care and Boston University, also revealed that kids are more likely to use asthma controller medications appropriately if they have a routine for taking medicine and if their parents clearly understand how well symptoms can be controlled.
"Our findings suggest that parents' expectations and perceptions are key factors influencing how well their children's asthma is controlled, and how effectively they use medications," said Dr. Tracy Lieu, the study's senior author.
For the study, the researchers surveyed more than 700 parents of children aged 2 to 12 years with persistent asthma who received care at Neighborhood Health Plan and Harvard Vanguard Medical Associates in Boston.
Parents were asked how well they believed their child's symptoms could be controlled, how asthma would or would not limit their child's activities and health, and about their child's actual asthma symptoms.
Also, parents were asked about other competing family priorities such as financial and job concerns, neighborhood safety, family relationships and their own health.
The researchers found that children were more likely to have troublesome symptoms if their parents had low expectations for how well their asthma could be controlled.
They were also more likely to have poorly controlled symptoms if there was no set time or routine for taking asthma medication.
The researchers found that concerns about other family issues and lack of parental knowledge about asthma were also related to worse asthma control.
Some parents mistakenly thought asthma is an intermittent rather than chronic condition, that two days of symptoms per week was adequate control, and that medication use was necessary only when their child had symptoms or not at all.
The researchers believe it is important that clinicians identify and work with parents who have low expectations about asthma control and educate them about treatments that can improve their child's condition.
"Raising parents' expectations for how well their children can be doing with asthma may be one of the keys to reducing racial/ethnic disparities in asthma outcomes," Lieu said.
The study appears in the Oct. 2008 issue of Pediatrics.