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Does parental involvement in pediatric emergency department asthma treatment affect home management?
Ambrin Hussain-Rizvi1, Sergey Kunkov, Ellen F Crain
1Lewis M Fraad Department of Pediatrics (Emergency Medicine), Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Insights
Parents using metered dose inhalers with spacers (MDIS) in the pediatric emergency department showed significantly higher adherence to home asthma treatment. This approach may improve medication adherence for children with asthma exacerbations.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Pharmacology
Background:
- Asthma exacerbations are a common reason for pediatric emergency department visits.
- Adherence to prescribed albuterol therapy is crucial for managing pediatric asthma.
- Traditional nebulizer therapy and metered dose inhaler with spacer (MDIS) are common treatment methods.
Purpose of the Study:
- To compare home adherence rates between parents administering albuterol via MDIS in the ED versus standard nebulizer therapy.
- To evaluate the impact of in-ED MDIS use on subsequent home treatment adherence.
Main Methods:
- A randomized study involving children aged 1-5 years with asthma exacerbations.
- Children were assigned to either standard nebulizer treatment or parent-administered MDIS treatment.
- Caregivers received standardized instructions and devices, with adherence assessed via telephone questionnaire at two weeks.
Main Results:
- Children treated with MDIS in the ED were 7.5 times more likely to use MDIS at home.
- This finding was statistically significant (95% CI 1.6-35.6).
Conclusions:
- Involving parents in asthma treatment using MDIS in the emergency department can significantly improve home adherence.
- MDIS may be a valuable tool for enhancing medication adherence in pediatric asthma management.
Abstract:
To determine whether parents who deliver albuterol treatments in a pediatric emergency department with a metered dose inhaler with a spacer device (MDIS) report better adherence to MDIS use at home compared to parents whose children undergo standard nebulizer therapy. Children aged 1-5 years were randomized by day to usual treatment with nebulized albuterol (40 children) or to treatment by the parent with albuterol with an MDIS (46 children). All caregivers received standard discharge instructions, a spacer and an MDI. Two weeks following the visit, a trained research assistant blinded to the child's group status, administered a brief telephone questionnaire to each caretaker. At follow-up, children in the MDIS group were 7.5 times more likely to be using the MDIS for their albuterol treatments (95%CI 1.6-35.6). Involving parents in treatment of asthma exacerbations in the emergency department using an MDIS may improve adherence to MDIS use at home.
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