68% of caregivers incorrectly treat children's asthma exacerbation with albuterol, most undertreat

Increased asthma morbidity and mortality is associated with inappropriate home self-management skills. This study included caregivers of 84 children with asthma aged 4 to 14 years, presenting to the emergency department (ED) with an asthma exacerbation. National Asthma Education and Prevention Program guidelines were used to classify home albuterol use as appropriate or inappropriate.

Home albuterol use for the current asthma exacerbation was categorized as:

- inappropriate in 68% of participants
- appropriate in 32%

Incorrect home albuterol use included:

- undertreating, including not giving albuterol frequently enough, and without albuterol at home.
- no spacer
- overtreating
- overreacting
- using a controller medicine for quick relief

Those with appropriate albuterol use were more likely to have their child hospitalized for asthma in the past 48 months.

A significant proportion of caregivers (68%) incorrectly treat children's asthma exacerbation with albuterol. Correctly assessing asthma symptom severity and appropriate home albuterol use may be linked to disease experience such as previous hospitalizations.

Incorrect and/or inappropriate use of medications is one of the major causes of difficult to control asthma:

Severe asthma - differential diagnosis and management (click to enlarge the image).

An asthma action plan may help. All patients with asthma should have such action plan.

The asthma action plan shows your daily treatment, such as what kind of medications to take and when to take them. Your plan describes how to control asthma long term AND how to handle worsening asthma, or asthma attacks. The plan explains when to call the doctor or go to the emergency room:

Asthma Action Plans

- Asthma Action Plan, adapted by Dr. Dimov (PDF)
- Asthma Action Plan, with added common medications, not branded for a specific physician  (PDF)
- NIH generic Asthma Action Plan (PDF)


Inappropriate home albuterol use during an acute asthma exacerbation. Clayton K, Monroe K, Magruder T, King W, Harrington K. Ann Allergy Asthma Immunol. 2012 Dec;109(6):416-9. doi: 10.1016/j.anai.2012.09.013. Epub 2012 Oct 11.

AllergyGoAway.com: How to use an asthma action plan and peak flow meter (videos)

Image source: ProAir-HFA Albuterol Sulfate (US), Wikipedia, public domain.

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