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Measured bronchodilator use in preschool children with asthma
A E Ferguson1, N A Gibson, T C Aitchison
1Department of Child Health, Royal Hospital for Sick Children, Glasgow.
Insights
Parents inconsistently administered bronchodilator medication to preschool children with asthma, often failing to treat symptoms. This variability highlights a gap in asthma symptom management for young children.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Pharmacological Interventions
Background:
- Asthma is a common chronic respiratory disease in preschool children.
- Effective management of asthma symptoms in young children relies on appropriate bronchodilator use.
- Understanding parental treatment patterns is crucial for optimizing pediatric asthma care.
Purpose of the Study:
- To investigate parental administration of bronchodilator treatment for symptom relief in preschool children with asthma.
- To assess the relationship between recorded asthma symptoms and bronchodilator use by parents.
Main Methods:
- A prospective study involving 29 preschool children with moderately severe asthma.
- Bronchodilator use was objectively measured using an electromechanical timer attached to a spacer device over two months.
- Parents maintained daily asthma diary cards to record symptoms and perceived inhaler use.
Main Results:
- Data from 22 children showed variable bronchodilator use, occurring on 63% of symptomatic days.
- Bronchodilator use frequency was not closely correlated with symptom severity in most children.
- Parents frequently recorded symptoms but did not administer bronchodilator treatment.
Conclusions:
- Parental administration of bronchodilator treatment for childhood asthma is inconsistent.
- A disconnect exists between recorded asthma symptoms and actual treatment provided by parents.
- Further research and educational interventions are needed to improve asthma management in preschool children.
Objective:
To investigate how parents use bronchodilator treatment for relief of symptoms when treating their asthmatic preschool children.
Design:
A commercial electromechanical timer device was attached to a large volume spacer to record the time and date of each use of inhaled bronchodilator over two months. The recorded time and dates were compared with symptoms noted in an asthma diary card.
Setting:
Large paediatric teaching hospital in Glasgow.
Subjects:
29 preschool children with moderately severe asthma attending a specialist paediatric asthma clinic.
Main Outcome Measures:
Inhaler use measured by the timer device; symptoms and inhaler use recorded by parents in a daily asthma diary.
Results:
Satisfactory data were obtained in 22 of the 29 children; the median number of study days was 53 (range 18-77). Asthmatic symptoms were recorded on a median of 30 (3-77) days. Bronchodilator was used on a median of 19 (2-73) days, or on 63% (7-100%) of days when symptoms occurred. The median number of puffs used in a day was 1 (range 0-100) and was significantly related to symptom severity in only 14 of the 22 children. In only two of the 22 children was bronchodilator given more frequently than four hourly, and only five children ever used more than 12 puffs a day.
Conclusions:
The frequency of parental administration of bronchodilator treatment was variable and not closely related to the parent's record of symptom severity. Parents often recorded symptoms in their children but did not treat them.