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Mumps cases have doubled in the last 12 months

Children with both asthma and allergic rhinitis are three times more likely to be admitted to hospital than those with asthma alone and significantly more costly to treat, a study concludes.

GP researchers said children with both conditions were at particularly high risk of asthma attacks and needed more intensive therapy and more frequent medication reviews.

Over a year, 1.4 per cent of children with both asthma and allergic rhinitis were admitted to hospital compared with 0.5 per cent of children with asthma alone.

And the study, published in this month's Pediatrics, found children with both conditions visited their GP an average of 4.4 times a year, compared with 3.4 times for those with asthma alone. Having both conditions raised medication costs by 16 per cent.

A second study by the same research group, due for publication shortly, found the results held true for adult patients.

Lead researcher Professor David Price, professor of primary care respiratory medicine at the University of Aberdeen, called for a review of the quality framework to include more comprehensive indicators for asthma control, including a question on whether patients had allergic rhinitis.

Professor Price, a sessional GP in Norfolk and chair of the research sub-committee of the General Practice Airways Group, said: 'Asthma guidelines have tended to focus on the lungs, but asthma is a systemic allergic disease ­ our guidelines have pushed us in slightly the wrong direction.

'It doesn't mean that other patients do not need review but this group need more review and possibly more intensive therapy.'

Professor Price suggested patients with asthma and rhinitis should initially be followed up every month to six weeks until control was achieved (see box).

Dr David Bellamy, a GP in Bournemouth and a member of the British Thoracic Society, said: 'This is an important new issue. This is a group of asthmatics who have more problems, although it doesn't mean GPs should not try to get good symptom control in all asthmatics.'

The research studied 9,522 children with asthma, of whom 1,879 also had allergic rhinitis.

Reviewing patients

with asthma and

rhinitis

·Initially follow up patients every month to six weeks until control is achieved, then every six months and finally once a year

·If asthma is controlled and rhinitis is mild, review once a year

Therapies that may

improve control

Nasal steroids

But children need to be aware that they are being given more steroids;

a more modern nasal steroid should be tried

Antihistamines

Tend to be better in mild rhinitis rather than poorly-controlled/severe rhinitis and asthma

Leukotriene receptor antagonists

Can treat both the rhinitis and the asthma

By Nerys Hairon

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