title: Nebulizer use in inner-city children with asthma: morbidity, medication use, and asthma management practices.
abstract: 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.
authors.affiliation: Department of Pediatrics, Johns Hopkins University, School of Medicine, 600 N Wolfe St, Baltimore, MD 21287-3144, USA. Abutz@jhmi.jhu.edu.
authors.forename: A M
authors.initials: AM
authors.lastname: Butz
authors.forename: P
authors.initials: P
authors.lastname: Eggleston
authors.forename: K
authors.initials: K
authors.lastname: Huss
authors.forename: K
authors.initials: K
authors.lastname: Kolodner
authors.forename: C
authors.initials: C
authors.lastname: Rand
mesh_terms: 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
chemical_list: D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D013256:Steroids