Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 149-157 |
| Number of pages | 9 |
| Journal | Pulmonary Therapy |
| Volume | 4 |
| Issue number | 2 |
| DOIs | |
| State | Published - Dec 2018 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2018, The Author(s).
Funding
This study was presented at Pediatric Academic Society 2018 in Toronto, Canada and travel was supported by the Women and Children’s Health Research Institute (WCHRI) Travel grant. The primary author was awarded a WCHRI Resident Trainee Grant (TYY). We would like to thank Dr. Michael Newhouse, MD, MSc, from McMaster University for his expertise and review of this manuscript. We would also like to thank all participants of this study. This study was presented at Pediatric Academic Society 2018 in Toronto, Canada and travel was supported by the Women and Children?s Health Research Institute (WCHRI) Travel grant. The primary author was awarded a WCHRI Resident Trainee Grant (TYY). We would like to thank Dr. Michael Newhouse, MD, MSc, from McMaster University for his expertise and review of this manuscript. We would also like to thank all participants of this study. No funding or sponsorship was received for this study or publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Telford Y Yeung, Christopher Ewing, Anna Malanowska, Michelle Balcom, and Janny Liu have nothing to disclose. The corresponding author, Israel Amirav, is a member of the editorial board for Pulmonary Therapy. He has also published a recent commentary on asthma action plans in December 2017. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. The dataset analyzed during the current study is available from the corresponding author on reasonable request. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
| Funders | Funder number |
|---|---|
| Children's Health Research Institute | |
| McMaster University | |
| Women and Children's Health Research Institute |
Keywords
- Action plan
- Asthma
- Asthma control
- Asthma management
- Children