Factors affecting the use of salbutamol before hospital admission in children with asthma exacerbation
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Keywords
asthma attack, beta-agonist, children, exacerbation, modified pulmonary index score, parents’ knowledge, salbutamol, severity
Abstract
Background: Early home intervention for asthma exacerbation (AE) in children is associated with more favorable outcomes. Inhaled short-acting beta2 agonists (SABA) are the cornerstones of AE treatment.
Objectives: We aimed to determine what proportion of parents administered salbutamol to their children to treat asthma exacerbation at home, and the factors affecting the decision to administer the medication. Additionally, we also aimed to examine the parents’ level of knowledge regarding salbutamol use.
Methods: Asthma patients who were admitted to pediatric allergy outpatient clinics due to AE were included in the study. Parents’ knowledge related to home salbutamol use was evaluated using a questionnaire. Modified Pulmonary Index Score was used to evaluate AE severity.
Results: The study included 177 children (64.4% males) with a median age of 6.16 years. Of these, 86 patients (48.6%) had not administered salbutamol before hospital admission, and parents of 69 (80%) patients stated that they knew salbutamol should be administered but they did not want to administer it without consulting a doctor. Of the 91 patients who had used salbutamol before hospital admission, 28 (30.7%) had administered the incorrect dose, 2 (2.2%) used the incorrect technique, and 9 (9.9%) had the incorrect dose and incorrect technique. In multivariate logistic regression analysis, history of hospitalizations (odds ratio [OR]: 6.35; 95% confidence interval [CI]: 3.07–13.9; P < 0.001), history of more than five exacerbations (OR: 4.51, 95%CI: 1.94–10.48; P < 0.001 ), and presence of sputum (OR: 2.54; 95%CI: 1.10–5.87; P = 0.028) were the main predictors of salbutamol use.
Conclusion: Asthma patients and their parents should be better educated and actively encouraged on the use of SABA at home during an AE.
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