Home use of albuterol for asthma exacerbations.
Home use of albuterol for asthma exacerbations.
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DOI：
10.1016/s1081-1206(10)60125-1
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发表时间：
2009-06
影响因子：
5.9
通讯作者：
Strunk, Robert C.
中科院分区：
文献类型：
--
作者：
Garbutt, Jane M.;Freiner, Donna;Highstein, Gabrielle R.;Nelson, Kyle A.;Smith, Sharon R.;Strunk, Robert C.
为了减少症状和急诊（艾德）就诊，国家哮喘教育和预防计划（NAEPP）指南建议早期使用沙丁胺醇和口服皮质类固醇治疗急性哮喘症状。然而，哮喘的艾德就诊是频繁的，通常发生在症状加重后的几天，特别是对于来自低收入城市社区的儿童。描述沙丁胺醇的家庭使用，并确定与适当使用沙丁胺醇相关的因素。在一项旨在减少低收入城市儿童紧急护理的随机试验中，干预组的114名护理人员与哮喘护士进行了结构化电话访谈，以评估其儿童急性哮喘症状的家庭管理。根据NAEPP的建议，将护理人员报告的沙丁胺醇使用分类为适当或不适当。只有68%的看护者认为使用沙丁胺醇治疗哮喘症状恶化是适当的，如果儿童在前一年因哮喘接受过艾德访视或住院治疗，则更有可能使用沙丁胺醇。其余32%的护理人员使用沙丁胺醇不当（过度或治疗不足）。适当的沙丁胺醇使用与护理人员报告有哮喘行动计划（AAP）或最近的初级保健提供者访问讨论哮喘维持治疗无关。照顾者报告说，他们会使用沙丁胺醇来治疗他们孩子恶化的哮喘症状，但许多人描述了不适当的使用。在家中正确使用沙丁胺醇的详细评估可以提供医疗保健提供者如何更好地教育和支持父母管理急性加重和更有效地使用AAP的见解。
To reduce symptoms and emergency department (ED) visits, the National Asthma Education and Prevention Program (NAEPP) guidelines recommend early treatment of acute asthma symptoms with albuterol and oral corticosteroids. Yet, ED visits for asthma are frequent and often occur several days after onset of increased symptoms, particularly for children from low-income urban neighborhoods. To describe home use of albuterol and identify factors associated with appropriate albuterol use. 114 caregivers in the intervention group of a randomized trial to reduce emergent care for low-income, urban children completed a structured telephone interview with an asthma nurse to assess home management of their child’s acute asthma symptoms. Albuterol use as reported by caregivers was categorized as appropriate or inappropriate based on NAEPP recommendations. Albuterol use for worsening asthma symptoms was categorized as appropriate for only 68% of caregivers and was more likely if the children had an ED visit or hospitalization for asthma in the prior year. The remaining 32% of caregivers used albuterol inappropriately (over or under treatment). Appropriate albuterol use was not associated with caregiver report of having an Asthma Action Plan (AAP) or a recent primary care provider visit to discuss asthma maintenance care. Caregivers reported they would use albuterol to treat their child’s worsening asthma symptoms, but many described inappropriate use. Detailed assessment of proper albuterol use at home may provide insight into how healthcare providers can better educate and support parents in their management of acute exacerbations and more effective use of AAPs.