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Effectiveness of nebulizer use-targeted asthma education on underserved children with asthma.

Abstract

OBJECTIVE

To determine the effectiveness of a home-based asthma education intervention in increasing appropriate nebulizer use and reducing symptom frequency, emergency department (ED) visits, and hospitalizations over 12 months.

DESIGN

A randomized clinical trial. Settings Pediatric primary care, pulmonary/allergy, and ED practices associated with the University of Maryland Medical System and The Johns Hopkins Hospital, Baltimore.

PARTICIPANTS

Children with persistent asthma, aged 2 to 9 years, with regular nebulizer use and an ED visit or hospitalization within the past 12 months. Children were randomized into the intervention (n = 110) or control (n = 111) group. Follow-up data were available for 95 intervention and 86 control children.

INTERVENTION

Home-based asthma education, including symptom recognition, home treatment of acute symptoms, appropriate asthma medication, and nebulizer practice.

MAIN OUTCOME MEASURES

Estimates of mean differences in asthma symptom frequency, number of ED visits and hospitalizations and appropriate quick relief, controller medication, and nebulizer practice over 12 months.

RESULTS

Of the 221 children, 181 (81.9%) completed the study. There were no significant differences in home nebulizer practice, asthma morbidity, ED visits, or hospitalizations between groups (P range, .11-.79). Although most children received appropriate nonurgent asthma care (mean, 2 visits per 6 months), more than one third of all children received at least 6 quick-relief medication prescriptions during 12 months, with no difference by group.

CONCLUSIONS

A nebulizer education intervention had no effect on asthma severity or health care use. Of concern is the high quick-relief and low controller medication use in young children with asthma seen nearly every 3 months for nonurgent care.

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  • Authors+Show Affiliations

    ,

    Division of General Pediatrics, Department of Pulmonary and Critical Care, The Johns Hopkins University Medical Institutions, 600 N. Wolfe Street, Baltimore, MD 21287, USA. abutz@jhmi.edu

    , , , , , , ,

    Source

    MeSH

    Asthma
    Child
    Child, Preschool
    Emergency Service, Hospital
    Female
    Health Education
    Hospitalization
    Humans
    Male
    Medically Underserved Area
    Nebulizers and Vaporizers
    Outcome Assessment (Health Care)

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    16754825

    Citation

    Butz, Arlene M., et al. "Effectiveness of Nebulizer Use-targeted Asthma Education On Underserved Children With Asthma." Archives of Pediatrics & Adolescent Medicine, vol. 160, no. 6, 2006, pp. 622-8.
    Butz AM, Tsoukleris MG, Donithan M, et al. Effectiveness of nebulizer use-targeted asthma education on underserved children with asthma. Arch Pediatr Adolesc Med. 2006;160(6):622-8.
    Butz, A. M., Tsoukleris, M. G., Donithan, M., Hsu, V. D., Zuckerman, I., Mudd, K. E., ... Bollinger, M. E. (2006). Effectiveness of nebulizer use-targeted asthma education on underserved children with asthma. Archives of Pediatrics & Adolescent Medicine, 160(6), pp. 622-8.
    Butz AM, et al. Effectiveness of Nebulizer Use-targeted Asthma Education On Underserved Children With Asthma. Arch Pediatr Adolesc Med. 2006;160(6):622-8. PubMed PMID: 16754825.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effectiveness of nebulizer use-targeted asthma education on underserved children with asthma. AU - Butz,Arlene M, AU - Tsoukleris,Mona G, AU - Donithan,Michele, AU - Hsu,Van Doren, AU - Zuckerman,Ilene, AU - Mudd,Kim Elizabeth, AU - Thompson,Richard E, AU - Rand,Cindy, AU - Bollinger,Mary Elizabeth, PY - 2006/6/7/pubmed PY - 2006/6/24/medline PY - 2006/6/7/entrez SP - 622 EP - 8 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 160 IS - 6 N2 - OBJECTIVE: To determine the effectiveness of a home-based asthma education intervention in increasing appropriate nebulizer use and reducing symptom frequency, emergency department (ED) visits, and hospitalizations over 12 months. DESIGN: A randomized clinical trial. Settings Pediatric primary care, pulmonary/allergy, and ED practices associated with the University of Maryland Medical System and The Johns Hopkins Hospital, Baltimore. PARTICIPANTS: Children with persistent asthma, aged 2 to 9 years, with regular nebulizer use and an ED visit or hospitalization within the past 12 months. Children were randomized into the intervention (n = 110) or control (n = 111) group. Follow-up data were available for 95 intervention and 86 control children. INTERVENTION: Home-based asthma education, including symptom recognition, home treatment of acute symptoms, appropriate asthma medication, and nebulizer practice. MAIN OUTCOME MEASURES: Estimates of mean differences in asthma symptom frequency, number of ED visits and hospitalizations and appropriate quick relief, controller medication, and nebulizer practice over 12 months. RESULTS: Of the 221 children, 181 (81.9%) completed the study. There were no significant differences in home nebulizer practice, asthma morbidity, ED visits, or hospitalizations between groups (P range, .11-.79). Although most children received appropriate nonurgent asthma care (mean, 2 visits per 6 months), more than one third of all children received at least 6 quick-relief medication prescriptions during 12 months, with no difference by group. CONCLUSIONS: A nebulizer education intervention had no effect on asthma severity or health care use. Of concern is the high quick-relief and low controller medication use in young children with asthma seen nearly every 3 months for nonurgent care. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/16754825/Effectiveness_of_nebulizer_use_targeted_asthma_education_on_underserved_children_with_asthma_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.160.6.622 DB - PRIME DP - Unbound Medicine ER -