Nebulizer Use in Inner-City Children With Asthma

Butz, Arlene; Eggleston, Peyton A.; Huss, Karen; Kolodner, Ken; Rańd, Cynthia S.

doi:10.1001/archpedi.154.10.984

Cited by 34 publications

(7 citation statements)

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“…Consistent with reports of others (10), we found high rates of nebulizer use observed in an inner-city school-age population with asthma (11). Approximately 45% of children enrolled in a communitybased asthma study reported having a nebulizer in the home and 33% of these school age children reported regular use of a nebulizer, defined as at least 1 or more days within the last month, in the management of their asthma (11).…”

Section: Introductionsupporting

confidence: 90%

“…Of the 686 children, almost half (312 children, 45%) reported having a nebulizer machine in the home and 231 of these children or 74% (231 of 312) reported current nebulizer use at least 1 or more days within the last month for the past 6 months for which results are presented (11). We previously reported on nebulizer use among innercity children with asthma (11). This paper presents additional data on self-care practices and asthma health beliefs among children with asthma who are currently using a nebulizer.…”

Section: Subjectsmentioning

confidence: 99%

“…Approximately 45% of children enrolled in a communitybased asthma study reported having a nebulizer in the home and 33% of these school age children reported regular use of a nebulizer, defined as at least 1 or more days within the last month, in the management of their asthma (11). Although nebulizers appear to be an important component of asthma management practice within inner-city communities, little is known regarding how nebulizers are integrated into the overall asthma therapy of inner-city children with asthma.…”

Section: Introductionmentioning

confidence: 99%

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Children with Asthma and Nebulizer Use: Parental Asthma Self-Care Practices and Beliefs

et al. 2001

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We examined demographic characteristics, patterns of medication use, asthma morbidity, and asthma self-management practices and beliefs among inner-city children currently using a nebulizer. We also describe the relationship between asthma self-management practices and beliefs and anti-inflammatory (AI) therapy. We observed a high rate of morbidity, including frequent emergency room visits, hospitalizations, symptom days and nights, and school absences in this group of school-aged children with asthma. More than three-quarters (81%) reported asthma symptoms consistent with mild persistent or greater severity of asthma, and therefore these subjects should be taking AI medications. Another 16% (36 of 231) of these children reported symptoms consistent with mild intermittent asthma. Only 1 out of 7 children in this study reported taking AI medications. We found that parents of children taking daily AI medications were more likely to agree with the belief that children should use asthma medications daily even when the child is not reporting any symptoms.

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Section: Introductionsupporting

confidence: 90%

Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Children with Asthma and Nebulizer Use: Parental Asthma Self-Care Practices and Beliefs

et al. 2001

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“…21 A cross-sectional study of inner-city children who were from Washington, DC, and Baltimore, Maryland, and had at least mild persistent asthma found that these children were high nebulizer users of ␤-agonists but low users of inhaled steroids. 22 Asthma medication utilization disparities have been reported in situations in which racial and ethnic differences in access barriers should be minimized. Joseph et al 23 reported that among children with asthma in a Michigan health maintenance organization (HMO), black children received fewer prescribed medications than white children when seeing nonspecialists.…”

mentioning

confidence: 99%

Impact of Site of Care, Race, and Hispanic Ethnicity on Medication Use for Childhood Asthma

et al. 2002

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ABSTRACT. Objective. To understand the importance of source of care and other factors that influence differences in asthma medication use by race and Hispanic ethnicity.Methods. The Childhood Asthma Severity Study provided 12-month, retrospective, parent-reported questionnaire data on a monthly basis for children ages <12 years in a community sample of 1002 children and their families from Connecticut and Massachusetts. Medications considered included cromolyn, ␤2-agonist, inhaled steroids, anticholinergics, theophylline, and systemic steroids. Information was available on demographics, insurance status, symptom severity, primary care contact, and provider practice types.Results. Black and Hispanic children received fewer ␤2-agonists, and Hispanic children received fewer inhaled steroids than white children after adjusting for patients' race, age, gender, insurance status, symptom severity, number of primary care visits for asthma, number of urgent visits to the regular provider, family income, maternal education, and site of care. When multivariate analyses were restricted to patients in private practice, the significant association between Hispanic ethnicity and low inhaled steroid use persisted, whereas differences in ␤2-agonist use by race and ethnicity changed little but became nonsignificant.Conclusion. Even within private practices, patients' race and ethnicity are associated with clinician nonadherence to national guidelines. Programs to eliminate these disparities will need both to focus on site of care and to intervene at the provider and patient levels to be successful. Pediatrics 2002;109(1). URL: http://www. pediatrics.org/cgi/content/full/109/1/e1; asthma, child, practice guidelines, health insurance, Hispanic Americans.

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“…4 -6 For example, in a recent survey, just 10% of inner-city children with persistent asthma were being treated with inhaled corticosteroids. 4 Others have reported that inner-city asthmatic children have poor adherence to national guidelines in response to a mock asthma exacerbation. 5,6 It has been a decade since the National Heart, Lung, and Blood Institute (NHLBI) published its asthma management guidelines.…”

mentioning

confidence: 99%

Patient Self-Management of Acute Asthma: Adherence to National Guidelines a Decade Later

2001

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Nebulizer Use in Inner-City Children With Asthma

Cited by 34 publications

References 38 publications

Children with Asthma and Nebulizer Use: Parental Asthma Self-Care Practices and Beliefs

Children with Asthma and Nebulizer Use: Parental Asthma Self-Care Practices and Beliefs

Impact of Site of Care, Race, and Hispanic Ethnicity on Medication Use for Childhood Asthma

Patient Self-Management of Acute Asthma: Adherence to National Guidelines a Decade Later

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