Home Management of Childhood Asthma Exacerbations

被引：3
作者：
Yeung T.Y. [1 ,2 ]
Ewing C. [3 ]
Malanowska A. [1 ]
Zuberbuhler P. [3 ]
Balcom M. [1 ]
Liu J. [1 ]
Amirav I. [1 ,2 ]
机构：
[1] Stollery Pediatric Pulmonary Clinic, 8440 112 Street, Edmonton, AB
[2] Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB
[3] Baker Pediatric Clinic, Edmonton, AB
来源：
Pulmonary Therapy | 2018年 / 4卷 / 2期
关键词：
Action plan; Asthma; Asthma control; Asthma management; Children;
D O I：
10.1007/s41030-018-0061-y
中图分类号：
学科分类号：
摘要：
Introduction: Effective home management of childhood asthma by caregivers requires education along with a written asthma action plan (AAP), which should outline clear instructions for treatment during exacerbations. However, a large number of asthma exacerbations continue to be managed in the emergency department (ED) and in hospitals, particularly in Canada. The objective of this study was to assess caregiver management of acute asthma at home following the 2015 Global Initiative for Asthma (GINA) guidelines and to identify factors that may be associated with deviations from these guidelines. Methods: 122 caregivers of children, aged 3–17 years, with physician diagnosed asthma, completed a paper-based questionnaire. Correct caregiver management (defined according to the GINA guidelines) of acute asthma as well as their use of an AAP were assessed. Results: Out of all caregivers, 74.6% incorrectly treated their child’s asthma exacerbation in a home setting. Among those who used an AAP, we observed significantly more ED visits (0.9 ± 1.2 versus 0.5 ± 0.9, p = 0.04) and hospitalizations (0.2 ± 0.4 versus 0.0 ± 0.0, p = 0.02) when compared to non-AAP users in the past 1 year. Conclusions: Caregivers of children with asthma in Canada may still lack skills for proper home management of asthma exacerbations. We found a higher number of ED visits and hospitalizations in those using an AAP compared to those who did not use an AAP. These data suggest that current AAPs may not be sufficient for home asthma management. © 2018, The Author(s).
引用
收藏
页码：149 / 157
页数：8
相关论文
共 25 条
[1]  
Garner R., Kohen D., Changes in the prevalence of asthma among Canadian children, Health Rep, 19, 2, pp. 45-50, (2008)
[2]  
To T., Dell S., Tassoudji M., Wang C., Health outcomes in low-income children with current asthma in Canada, Chronic Dis Can, 29, 2, pp. 49-55, (2009)
[3]  
Gibson P.G., Powell H., Wilson A., Et al., Self-management education and regular practitioner review for adults with asthma, Cochrane Database Syst Rev, 1, (2003)
[4]  
Lougheed M.D., Lemiere C., Ducharme F.M., Licskai C., Dell S.D., Rowe B.H., Fitzgerald M., Leigh R., Watson W., Boulet L.P., Canadian Thoracic Society asthma clinical assembly. Canadian Thoracic Society 2012 guideline update: diagnosis and management of asthma in preschoolers, children and adults, Can Respir J, 19, 2, pp. 127-164, (2012)
[5]  
Global Strategy for Asthma Management and Prevention, (2015)
[6]  
Zemek R.L., Bhogal S.K., Ducharme F.M., Systematic review of randomized controlled trials examining written action plans in children: What is the plan?, Arch Pediatr Adolesc Med, 162, pp. 157-163, (2008)
[7]  
Larson A., Ward J., Ross L., Whyatt D., Weatherson M., Landau L., Impact of structured education and self-management on rural asthma outcomes, Aust Fam Physician, 39, pp. 141-144, (2010)
[8]  
Ortiz-Alvarez O., Mikrogianakis A., Managing the pediatric patient with an acute asthma exacerbation, Paediatr Child Health, 17, pp. 251-255, (2012)
[9]  
Rosychuk R.J., Voaklander D.C., Klassen T.P., Senthilselvan A., Marrie T.J., Rowe B.H., Asthma presentations by children to emergency departments in a Canadian province: A population-based study, Pediatr Pulmonol, 45, 10, pp. 985-992, (2010)
[10]  
Nath J.B., Hsia R.Y., Children’s emergency department use for asthma 2001–2010, Acad Pediatr, 15, pp. 225-230, (2015)
123