 |
|
Nebulizer Use in Inner-City Children With Asthma
Morbidity, Medication Use, and Asthma Management Practices
Arlene M. Butz, ScD, RN;
Peyton Eggleston, MD;
Karen Huss, DNSc, RN, FAAN;
Ken Kolodner, PhD;
Cynthia Rand, PhD
Arch Pediatr Adolesc Med. 2000;154:984-990.
Objective To assess the frequency of nebulizer use, describe morbidity and patterns of medication administration, and examine the potential relationships between inhaled anti-inflammatory medication administration, asthma morbidity, and asthma management practices in children with asthma using a nebulizer compared with children with asthma not using a nebulizer.
Research Design A cross-sectional, descriptive survey of previous events.
Setting Elementary schools and participants' homes in Baltimore, Md, and Washington, DC.
Participants Six hundred eighty-six families of children aged 5 to 12 years with a diagnosis of at least mild, persistent asthma.
Interventions None.
Measurements and Main Results Asthma morbidity, health care utilization, pattern of asthma medication administration, nebulizer use, and asthma management data were collected by telephone survey administered to caregivers. Nebulizer use was defined as use at least 1 or more days per month during the last 6 months. Of 686 children identified, 231 (33%) reported current nebulizer use. Nebulizer users had significantly increased lifetime hospital admissions, hospitalizations, and emergency department visits in the last 6 months compared with nonnebulizer users. Inhaled corticosteroid administration was low for both groups (nonnebulizer users, 8%; nebulizer users, 15%). In the nebulizer users group, administration of inhaled anti-inflammatory medications was associated with increased asthma morbidity (increased hospitalizations, days and nights with symptoms, and oral steroid use).
Conclusions Nebulizer use by inner-city children with asthma is higher than anticipated but is not associated with reduced asthma morbidity. This group of high-risk children was undertreated with inhaled corticosteroids for long-term control of asthma despite reports of adequate monitoring by a primary care physician.
From Departments of Pediatrics (Drs Eggleston and Butz) and Pulmonary Medicine (Dr Rand), The Johns Hopkins University School of Medicine, and the School of Nursing (Drs Butz and Huss), and Innovative Medical Research, INC (Dr Kolodner), Baltimore, Md.
RELATED ARTICLES
Remembering the Patient
Peter J. Gergen
Arch Pediatr Adolesc Med. 2000;154(10):977-978.
EXTRACT
| FULL TEXT
Higher-Dose Intravenous Magnesium Therapy for Children With Moderate to Severe Acute Asthma
Lydia Ciarallo, David Brousseau, and Steven Reinert
Arch Pediatr Adolesc Med. 2000;154(10):979-983.
ABSTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Effectiveness of Nebulizer Use-Targeted Asthma Education on Underserved Children With Asthma
Butz et al.
Arch Pediatr Adolesc Med 2006;160:622-628.
ABSTRACT
| FULL TEXT
Factors Associated with Preventive Asthma Care in Inner-City Children
Butz et al.
CLIN PEDIATR 2004;43:709-719.
ABSTRACT
Demonstrated Use of Metered-Dose Inhalers and Peak Flow Meters by Children and Adolescents With Acute Asthma Exacerbations
Scarfone et al.
Arch Pediatr Adolesc Med 2002;156:378-383.
ABSTRACT
| FULL TEXT
|
