Home use of albuterol for asthma exacerbations.
BACKGROUND
To reduce symptoms and emergency department (ED) visits, the National Asthma Education and Prevention Program (NAEPP) guidelines recommend early treatment of acute asthma symptoms with albuterol and oral corticosteroids. Yet, ED visits for asthma are frequent and often occur several days after onset of increased symptoms, particularly for children from low-income, urban neighborhoods.


OBJECTIVE
To describe home use of albuterol and identify factors associated with appropriate albuterol use.


METHODS
A total of 114 caregivers in the intervention group of a randomized trial to reduce emergent care for low-income, urban children completed a structured telephone interview with an asthma nurse to evaluate home management of their child's acute asthma symptoms. Interviews lasted approximately 20 minutes and were conducted from November 5, 2003, through September 30, 2005. Albuterol use as reported by caregivers was categorized as appropriate or inappropriate based on NAEPP recommendations.


RESULTS
Albuterol use for worsening asthma symptoms was categorized as appropriate for only 68% of caregivers and was more likely if the children had an ED visit or hospitalization for asthma in the prior year. The remaining 32% of caregivers used albuterol inappropriately (overtreatment or undertreatment). Appropriate albuterol use was not associated with caregiver report of having an asthma action plan (AAP) or a recent primary care physician visit to discuss asthma maintenance care.


CONCLUSIONS
Caregivers reported that they would use albuterol to treat their child's worsening asthma symptoms, but many described inappropriate use. 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 AAPs.
Garbutt
Jane M
JM
Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA. jgarbutt@im.wustl.edu
Freiner
Donna
D
Highstein
Gabrielle R
GR
Nelson
Kyle A
KA
Smith
Sharon R
SR
Strunk
Robert C
RC
D000420:Albuterol / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008923:Missouri; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D000420:Albuterol