Asthma Clinical Trial
Official title:
Nebulizer Intervention for Minority Children With Asthma
To determine if teaching parents and children to identify the child's asthma symptoms early and if teaching the appropriate use of a nebulizer will result in a decrease in emergency department visits.
Nebulizer use in young children is common with prevalence of 33-71% in children under age 12
years. Nebulizers are used primarily to administer SABA medications, (i.e., albuterol) and
some anti-inflammatory medications (i.e., budesonide, cromolyn). Parents may prefer
nebulizer delivery due to the inability of young children to coordinate respiration with
aerosol delivery and many parents lack confidence in administering metered-dose inhaler
(MDI) medications to young children. Physician preference for nebulizer administration of
asthma medications is low, but is favored due to direct medication delivery to the
respiratory system despite studies indicating MDIs with spacers are as effective as
nebulizers in delivering asthma medications to young children. Although national guidelines
recommend a nebulizer with mask for children 2 years or younger most asthma educational
programs lack specific content addressing appropriate nebulizer technique including when and
what symptoms to treat at home, optimal length of a nebulized medication session, prevention
of SABA overuse and appropriate cleaning and maintenance of the device. Because the overuse
of home nebulizer SABA medications has been associated with fatal asthma, instruction and
supervision of nebulized rescue medication delivery in addition to appropriate preventive
medication use may reduce asthma morbidity and mortality .
The current study was conducted to determine the effectiveness of a home-based nebulizer
educational intervention (NEI) for young children with asthma. The intervention was designed
to teach early symptom recognition, appropriate medication use and nebulizer technique for
home treatment of acute asthma episodes. Study outcomes included symptom frequency, activity
limitation, emergency department (ED) visits and hospitalizations, appropriate asthma
medication use and nebulizer practice. We hypothesized that children receiving the NEI would
demonstrate improvement in appropriate nebulizer and asthma medication use and decreased
asthma symptoms, activity limitation, ED visits and hospitalizations.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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