Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Parents often wait too long to treat children's asthma symptoms

12.02.2010
Parents of young children with asthma often recognize signs that their child is about to have an asthma attack but delay home treatment until the attack occurs, researchers at Washington University School of Medicine in St. Louis report.

Results of the study, published in the Annals of Allergy, Asthma and Immunology, show there are missed opportunities to intervene early and thus relieve a child's symptoms, possibly reduce the extent of the attack and prevent visits to the emergency room.

The study stems from comments received by two lay asthma coaches employed by Washington University School of Medicine. The coaches are trained to help educate families dealing with asthma by offering information and social support. They also have asthma themselves or a family member who has it.

While talking to parents of children with asthma, the coaches noticed that parents were often unsure of exactly how to use albuterol, a bronchodilator that relaxes muscles in the airways and increases airflow to the lungs, when they noticed signs that their child's asthma symptoms were worsening. The study followed up on those observations to determine if they are true among a larger group.

Asthma is one of the most common childhood diseases in the United States. Every year, two of every three children with asthma have at least one attack, or exacerbation. These exacerbations often result in missed school days, visits to the emergency room and hospitalizations. But researchers at the School of Medicine say some of these exacerbations could be prevented with early home treatment with albuterol.

For the study, the coaches telephoned 101 parents of children ages 2-12 who had recent visits to the emergency department at St. Louis Children's Hospital with an asthma exacerbation or who had called the hospital's After Hours Call Center. More than 60 percent of the families had Medicaid insurance. The coaches surveyed the parents about how they detected that their child was about to have an asthma attack and what they did to prevent or treat it.

Parents reported noticing signs such as coughing, wheezing, shortness of breath, chest tightness or pain, cold or allergy symptoms, or even behavioral signs such as becoming quiet or more temperamental.

"Every time the child had an exacerbation, many parents noticed the same medley of signs preceding it," says Jane Garbutt, M.B., Ch.B., associate professor of medicine and of pediatrics. "But even though they noticed the signs consistently, they often didn't do anything about it. If parents had known to give albuterol earlier, they may have been able to manage things at home and avoid a trip to the emergency room," says Garbutt, also director of the Washington University Pediatric and Adolescent Ambulatory Research Consortium.

Garbutt says one of the reasons parents may not begin treatment is that they believe they are following doctor's instructions.

"The asthma plan from the doctor often says to start using albuterol when parents notice the child is wheezing or coughing or short of breath, but the doctor may have a different definition for those symptoms than the parent," Garbutt says.

Another problem the researchers found was that parents may not notice some of the early signs that predict an exacerbation. One in four parents who was interviewed reported seeing late signs of an exacerbation in the child, including gasping for breath or sucking in the rib muscles when breathing.

"Those kids have to go to the emergency department because they are too far along in their exacerbation to do anything at home," Garbutt says. "If we can talk to parents and find out that's the issue, we can teach them to take action sooner."

In some instances, parents knew they needed to give their child albuterol, but weren't sure how much or how often.

"Parents varied in terms of how often they used it, if they used it with a nebulizer, how often they repeated it and how they determined if it was working," Garbutt says. "A careful assessment of exactly which medicines are used and how they are administered and dosed could identify problems. We think that is something that can be addressed with education."

Prednisone is a corticosteroid that prevents the release of inflammatory-causing substances in the body. Many parents said they kept the drug on hand at home in case of an asthma attack, but few parents in this study used it, instead calling the doctor's office or going to the emergency room.

Garbutt and fellow researchers are conducting a follow-up study in which the asthma coaches are working with physicians to promote earlier use of albuterol as well as other effective self-management behaviors. In addition, the coaches are working with parents to help them identify the early signs of an asthma exacerbation by giving parents a symptom diary to help parents see symptom patterns.

Garbutt J, Highstein G, Nelson K, Rivera-Spoljaric K, Strunk, R. Detection and home management of worsening asthma symptoms. Annals of Allergy, Asthma & Immunology, December 2009, pp. 469-473

Funding for this study was provided by the National Heart, Lung, and Blood Institute

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

Beth Miller | EurekAlert!
Further information:
http://www.wustl.edu

More articles from Studies and Analyses:

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Terahertz spectroscopy goes nano

20.10.2017 | Information Technology

Strange but true: Turning a material upside down can sometimes make it softer

20.10.2017 | Materials Sciences

NRL clarifies valley polarization for electronic and optoelectronic technologies

20.10.2017 | Interdisciplinary Research

VideoLinks
B2B-VideoLinks
More VideoLinks >>>