Caregivers of Asthmatic Children Fail to Use Albuterol Properly

Newswise — Nearly one third of caregivers in low-income, urban areas used albuterol improperly in the home when treating children for acute asthma symptoms, according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

Jane M. Garbutt, MB, ChB, FRCP (C), associate professor of medicine and pediatrics, medical director of Washington University Pediatric/Adolescent Ambulatory Research Consortium, Washington University School of Medicine, St. Louis, Mo., and colleagues, report that 32 percent of 114 caregivers in the intervention group of a randomized trial to reduce emergent care for low-income urban children used albuterol inappropriately (over-treatment or under-treatment).

"Albuterol is the most effective treatment for providing prompt relief from worsening asthma systems and is recommended for home use, guided by an asthma action plan," note the authors.

The caregivers completed a structured telephone interview with an asthma nurse to evaluate home management of their child's acute asthma symptoms. Albuterol use for worsening asthma symptoms was categorized as appropriate for only 68 percent of caregivers, and was more likely if the children had an emergency department visit or hospitalization for asthma in the prior year.

Reportedly having an asthma action plan, or a recent primary care physician visit to discuss asthma maintenance care, did not increase the likelihood that albuterol use was appropriate.

"Caregivers reported that they would use albuterol to treat their child's worsening asthma symptoms, but many described inappropriate use," the authors conclude. "Detailed evaluation of proper albuterol use at home may provide insight into how health care professionals can better educate and support parents in their management of acute exacerbations and more effective use of asthma action plans."

The National Asthma Education and Prevention Program (NAEPP) guidelines recommend early treatment of acute asthma symptoms with albuterol and oral corticosteroids.

Patient information on asthma and other allergic diseases is available by calling the ACAAI toll free number at (800) 842-7777 or visiting its Web site at www.acaai.org.

The American College of Allergy, Asthma and Immunology (ACAAI) is a professional medical organization headquartered in Arlington Heights, Ill., that promotes excellence in the practice of the subspecialty of allergy and immunology. The College, comprising more than 5,000 allergists-immunologists and related health care professionals, fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research.

Citation: Garbutt JM, et al. Home use of albuterol for asthma exacerbations. Ann Allergy Asthma Immunol 2009;102:504-509.

Annals of Allergy, Asthma & Immunology is online at www.annallergy.org.