Nebulizer use in inner-city children with asthma: morbidity, medication use, and asthma management practices.
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.


METHODS
A cross-sectional, descriptive survey of previous events.


METHODS
Elementary schools and participants' homes in Baltimore, Md, and Washington, DC.


METHODS
Six hundred eighty-six families of children aged 5 to 12 years with a diagnosis of at least mild, persistent asthma.


METHODS
None.


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.
Butz
A M
AM
Department of Pediatrics, Johns Hopkins University, School of Medicine, 600 N Wolfe St, Baltimore, MD 21287-3144, USA. Abutz@jhmi.jhu.edu.
Eggleston
P
P
Huss
K
K
Kolodner
K
K
Rand
C
C
D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D015142:Baltimore / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009017:Morbidity; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012646:Self Administration / Q000379:methods* / Q000706:statistics & numerical data; D013256:Steroids; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D013256:Steroids