title: Identifying parental preferences for corticosteroid and inhaled beta-agonist delivery mode in children with acute asthma exacerbations.
abstract: This study examines caregiver preferences of single-dose dexamethasone (DEX) versus 5-day oral prednisolone in treating acute asthma exacerbation in a pediatric emergency department (PED). A secondary objective was preference for mode of home inhaled β-agonist administration. Caregivers of patients 2 to 18 years with an acute asthma exacerbation treated in the PED completed a 1-page questionnaire including asthma history and preferences for steroids and β-agonist administration. One hundred caregivers completed the questionnaire. Within the preceding year, 79% had an asthma exacerbation and 73.7% (n = 99) were prescribed prednisolone. DEX was preferred by 79% of caregivers. Preferences were independent of caregiver demographics except in cases of prior intensive care admission, where DEX was less favored (odds ratio = 0.27, P < .046). No difference existed in mode of home β-agonist administration. Most caregivers prefer DEX in acute asthma exacerbation management. No difference exists for home β-agonists. These results may advise clinical practice in pediatric acute asthma exacerbation.
authors.affiliation: Vanderbilt University, Nashville, TN, USA sarah.m.szlam@vanderbilt.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Szlam
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: Donald H
authors.initials: DH
authors.lastname: Arnold
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D000318:Adrenergic beta-Agonists; D005938:Glucocorticoids; D003907:Dexamethasone; D011239:Prednisolone
keywords: acute asthma exacerbation; pediatric emergency medicine