Home Nebuliser Use in Children with Asthma in Two Scottish Health Board Areas

Madge, Philippa; Nisbet, Lorna A.; McColl, John H.; Vallance, A; Paton, James Y.; Beattie, James

doi:10.1177/003693309504000505

Cited by 9 publications

(6 citation statements)

References 6 publications

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“…Further, messages from this early look at the literature about some clinical interventions delivered at home were mixed: increased infections in children with cancer cared for at home, 8 but cheaper and equally effective chemotherapy at home; 9 infected nebulisers used for treatment of cystic fibrosis at home, [10][11][12] poorly controlled asthma with home nebulisers, 13 sometimes associated with incorrect use, 14 yet lowered emergency hospital visits and admissions when using home nebulisers for asthma; 15 higher rates of catheter infection in total parenteral nutrition (TPN) at home for children compared with adults, 16 yet less infection in central venous catheters at home than in hospital, 17 and longlasting and safe lines; 18 deep vein thrombosis, 19 embolism and septicaemia 20 in parenteral nutrition; higher rates of contamination in enteral feeds at home than in hospital 21 and poor standards of care for enteral nutrition. 22 By contrast, home ventilation therapy seemed to have a somewhat better 'press' 23,24 with suggestions that, compared with prolonged hospital care, it was both safer and cheaper.…”

Section: The Need For Evaluationmentioning

confidence: 99%

“…Nebulisers can be useful for those having frequent acute attacks or for children who are too young to use simpler devices. 13 However, a survey in the mid-1990s suggested that the provision and management of paediatric nebuliser services are poor and that "with the development of simpler, and less expensive, inhalational devices, nebulisers may even be inappropriate for many…children" 13 (p.143).…”

Section: Nebuliser Therapymentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of the costs and effectiveness of different models of paediatric home care

Parker

Bhakta

Lovett

et al. 2002

Health Technol Assess

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et al. A systematic review of the costs and effectiveness of different models of paediatric home care. Health Technol Assess 2002;6(35). Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA website (see opposite). NHS R&D HTA Programme T he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme. This has meant that the HTA panels can now focus more explicitly on health technologies ('health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care) rather than settings of care. Therefore the panel structure has been redefined and replaced by three new panels: Pharmaceuticals; Therapeutic Procedures (including devices and operations); and Diagnostic Technologies and Screening. The HTA Programme continues to commission both primary and secondary research. The HTA Commissioning Board, supported by the National Coordinating Centre for Health Technology Assessment (NCCHTA), will consider and advise the Programme Director on the best research projects to pursue in order to address the research priorities identified by the three HTA panels. The research reported in this monograph was funded as project number 98/05/03. The views expressed in this publication are those of the authors and not necessarily those of the HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for any recommendations made by the authors. Criteria for inclusion in the HTA monograph series Reports are published in the HTA monograph series if (1) they have resulted from work commissioned for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors. Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others.

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Section: The Need For Evaluationmentioning

confidence: 99%

Section: Nebuliser Therapymentioning

confidence: 99%

A systematic review of the costs and effectiveness of different models of paediatric home care

Parker

Bhakta

Lovett

et al. 2002

Health Technol Assess

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“…1, 10-12 Among children with asthma, the prevalence of sleep problems is higher, with 40-60% having some difficulty. 13, 14 Children with asthma are nearly four times more likely to experience sleep disordered breathing (SDB), 15 resulting in sleep disruption and decreased sleep efficiency, 16 reduced sleep quality, increased nighttime activity levels, 17 and more difficulties with daytime sleepiness. 16, 18 Sleep efficiency has been shown to improve with effective treatment of asthma symptoms, 16 but even children with clinically stable asthma have worse sleep quality and more daytime sleepiness than children without asthma.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Secondhand Smoke Exposure and Sleep Patterns in Children

Yolton¹,

Xu²,

Khoury

et al. 2010

Pediatrics

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Objectives Exposure to second hand smoke has been linked with multiple health problems in childhood. However, there have been limited investigations into the potential effect of second hand smoke exposure on child sleep patterns. The area warrants investigations since inadequate sleep in children has been linked to daytime emotional dysregulation, behavior problems, learning difficulties, and obesity, all of which carry significant morbidity beyond the respiratory ailments traditionally associated with second hand smoke exposure. The objective of this study was to investigate the relationship between exposure to second hand smoke and child sleep patterns among a group of children with asthma who were regularly exposed to tobacco smoke at home. Methods We studied 219 children who were enrolled in an asthma intervention trial and regularly exposed to second hand smoke. Serum cotinine was used to measure exposure to tobacco smoke, and sleep patterns were assessed by parent report using the Children's Sleep Habits Questionnaire (CSHQ). Covariates in adjusted analyses included: sex, age, race, maternal marital status, education, and income, prenatal tobacco exposure, maternal depression, HOME total score, household density, asthma severity, and use of asthma medications. Results Exposure to second hand smoke was associated with sleep problems including longer sleep onset delay (p=.004), sleep disordered breathing (p = .02), parasomnias (p=.002), daytime sleepiness (p=.022), and overall sleep disturbance (p=.0002). Conclusions We conclude that exposure to second hand smoke is associated with increased sleep problems among children with asthma.

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“…Recent trends in asthma care encourage early initiation of home nebulizer use for relief of acute, severe symptoms, especially in young children, 15,18 to decrease ED visits and hospitalization. 19,20 See also pages 977 and 979…”

mentioning

confidence: 99%