About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Kids with Mild Asthma can Use Inhalers as Needed

by Iswarya on August 17, 2019 at 12:00 PM
Font : A-A+

Kids with Mild Asthma can Use Inhalers as Needed

Kids with mild asthma can efficiently manage the condition by using either steroid inhalers or bronchodilator when symptoms occur, reveals a new study. The findings of the study are published in the Journal of Allergy and Clinical Immunology: In Practice.

This is in contrast to the traditional method of using the steroid daily, regardless of symptoms, and the bronchodilator when symptoms occur. The as-needed use of both inhalers is just as effective for mild asthma as the traditional protocol, according to the investigators.

Advertisement


The research focused on African American children, who are disproportionately affected by asthma.

"We were pleased to find that as-needed treatment based on symptoms can deliver similar asthma control with less medication," said first author Kaharu Sumino, MD, an associate professor of medicine.
Advertisement

"Patients in the group that used both inhalers as needed used about one-fourth the steroid dose of the group that inhaled a prescribed daily amount. We also were pleased to see that the patients and families felt that they had more ownership over their asthma management when practicing as-needed treatment."

In the U.S., about 6.2 million children under age 18 have asthma. Among white children, about 7.4 percent have asthma. Among African American children, that statistic is almost double, at 13.4 percent. According to the Allergy and Asthma Foundation of America, asthma attacks account for 1.8 million emergency room visits per year, and African Americans are three times more likely than average to be hospitalized due to asthma.

The study was conducted by primary care doctors at multiple pediatric practices throughout the St. Louis area, suggesting the strategy is widely applicable in a primary care setting and not just effective when implemented by researchers at a single academic medical center.

Past clinical trials conducted in the highly controlled settings of academic medical centers had suggested that the medication-as-needed approach worked just as well as a traditional strategy of daily scheduled steroid treatments with a rescue inhaler as needed. But how well that strategy might transfer to individual community medical practices had been an open question. Not only is this alternative, as-needed, symptom-based strategy effective when administered by the children's primary care doctors, but the researchers also found that approach reduced the amount of steroid medication the children took monthly by almost 75 percent.

The study included 206 African American children 6 to 17 years of age with mild asthma that was adequately controlled with asthma controller steroid medication. Participants saw their own pediatricians at 12 primary care providers throughout St. Louis. The patients were randomly assigned to one of two groups. Each participant in one group was advised to take a dose from an inhaler containing the steroid beclomethasone as needed when symptoms arose, along with the rescue bronchodilator albuterol. Symptoms that might prompt the use of medication include shortness of breath, tightness in the chest, coughing, wheezing, and difficulty performing physical activities.

Each participant in the second group was advised to take a specific inhaled dose of the steroid beclomethasone daily, regardless of symptoms, plus the rescue bronchodilator as needed in response to symptoms, as has been the standard recommendation for almost 30 years by the Global Initiative for Asthma guidelines.

At the end of the one-year study, the researchers found no differences between groups in surveys of how well the patients' asthma was controlled, as well as no differences in breathing tests that measure lung function. There also were no differences in the number of participants who sought extra medical care -- such as office or emergency room visits -- for asthma attacks.

As might be expected, the group taking daily beclomethasone, an inhaled corticosteroid, used more of the medication per month than those in the symptom-based group. On average, children in the daily-use group used 1,961 micrograms per month, while the symptom-based group used 526 micrograms per month, cutting the amount of this medication by almost three-fourths. The reduced amount is desirable, according to the investigators, because steroids have side effects that include stunted growth.

"Many families are concerned about the cost of this medication as well as the growth-related side effects, and stop taking their steroid medicine altogether. So it's nice to show that less medication -- used as needed -- is just as effective," Sumino said.

"This as-needed steroid plus rescue albuterol strategy is now recommended in the Global Initiative for Asthma guidelines as one of the options for the treatment of mild asthma. Given the result of our study and others, primary care doctors may tell their patients with mild asthma that they have an effective alternative strategy other than taking the inhaled steroid every day if they prefer not to do so."

The researchers also noted that children and caregivers in the group taking medication as needed reported that they felt they were actively managing their asthma care rather than passively relying on doctors' orders. The symptom-based strategy, in other words, gave them a sense of ownership over their asthma management, which is important in the long-term control of the disease, according to the Sumino and her colleagues.

Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
First-Ever Successful Pig-To-Human Kidney Transplantation
World Osteoporosis Day 2021 -
Spirituality and Mental Health
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Childhood Asthma Asthma Height and Weight-Kids Remedies for Seasonal Allergy Relief Allergy - Symptom Evaluation Wheezing Churg-Strauss Syndrome Tests for Asthma Stay Well This Winter Occupational Asthma 

Recommended Reading
Asthma
It's a lung condition characterized by inflammation of the bronchi and constriction of the airways ....
Tests for Asthma
Do you find it difficult to breathe especially during the cold weather? You may need to get tested ....
Millions of Children Develop Asthma Due to Traffic Pollution
Traffic pollution increases the risk of asthma in children in urban areas. Nearly 4 million ......
Allergy - Symptom Evaluation
An allergic reaction may be mild or severe. It usually involves the skin, respiratory system, eyes,...
Childhood Asthma
Childhood asthma is a condition that affects airways in children and interferes with their daily act...
Churg-Strauss Syndrome
Churg-Strauss Syndrome is a rare disease characterized by inflammation of blood vessels that can res...
Occupational Asthma
Occupational Asthma (OA) is a lung disorder that occurs due to exposure to toxic substances at the w...
Remedies for Seasonal Allergy Relief
Understanding the cause and mechanism of seasonal allergy can help in choosing the right treatment. ...
Stay Well This Winter
Winter is associated with staying huddled indoors, people scurrying home to escape the piercing wint...
Wheezing
Wheezing is a sound arising from the airways due to an obstruction or narrowing, which prevents the ...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use