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Drugs Used in Lower Respiratory Disorders: Overview01:17

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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
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Decrease in the use of bronchodilators in the management of bronchiolitis after applying improvement initiatives.

David Andina Martínez1, Silvia Escalada Pellitero1, Pedro Viaño Nogueira2

  • 1Servicio de Urgencias, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Anales De Pediatria
|June 1, 2022
PubMed
Summary

A quality improvement strategy significantly reduced bronchodilator use in acute bronchiolitis cases. This approach effectively decreased salbutamol and epinephrine prescriptions in the Emergency Department without impacting patient outcomes.

Keywords:
Bronchodilator agentsBroncodilatadoresBronquiolitis agudaEmergency medical servicesEstrategia de mejora de la calidadGuías de práctica clínicaHospital pediatricsPediatría hospitalariaPractice guidelinesQuality improvementServicios de UrgenciasViral bronchiolitis

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Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Quality Improvement

Background:

  • Acute bronchiolitis treatment shows significant clinical practice variability.
  • Ineffective treatments are often used despite clinical practice guideline recommendations.

Purpose of the Study:

  • To evaluate the impact of a quality improvement strategy on bronchodilator use in acute bronchiolitis.
  • To assess changes in salbutamol and epinephrine prescription rates over time.

Main Methods:

  • A five-year quality improvement strategy was implemented in the Emergency Department for acute bronchiolitis care.
  • A retrospective study analyzed bronchodilator prescription rates during four epidemic periods (2012, 2014, 2016, 2018).

Main Results:

  • Salbutamol use decreased from 51.2% in 2012 to 7.8% in 2018 (P < .001).
  • Epinephrine prescription rates fell from 12.9% to 0.2% (P < .001).
  • Emergency Department attendance time and admission rates decreased without affecting readmission rates.

Conclusions:

  • Systematic, continuous quality improvement actions can effectively reduce bronchodilator use in acute bronchiolitis.
  • This strategy appears effective in decreasing salbutamol and epinephrine prescriptions in the Emergency Department prior to the epidemic season.