Implementation of spacer therapy for acute asthma in children.
Vandeleur, M Chróinín, M N Ní
Vandeleur, M
Chróinín, M N Ní
Author
Advisors
Editors
Other Contributors
Date
2009-09
Date Submitted
Keywords
Other Subjects
Subject Mesh
Acute Disease
Adrenal Cortex Hormones
Albuterol
Asthma
Bronchodilator Agents
Child
Child, Preschool
Education, Continuing
Evidence-Based Medicine
Female
Great Britain
Humans
Ireland
Male
Medication Adherence
Metered Dose Inhalers
Practice Guidelines as Topic
Referral and Consultation
Retrospective Studies
Time Factors
Adrenal Cortex Hormones
Albuterol
Asthma
Bronchodilator Agents
Child
Child, Preschool
Education, Continuing
Evidence-Based Medicine
Female
Great Britain
Humans
Ireland
Male
Medication Adherence
Metered Dose Inhalers
Practice Guidelines as Topic
Referral and Consultation
Retrospective Studies
Time Factors
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
The aim was to develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination. Children admitted to Cork University Hospital Paediatric Department with acute asthma were identified during two identical 2 month seasonal periods before (2005) and after (2006) implementation of the new guidelines in September 2006. Pre-intervention and post-intervention audits by case note review were performed to determine the impact of and compliance with this evidence-based guideline emphasising patient assessment, spacer delivered bronchodilator and specific discharge criteria. Patients had similar characteristics during the two study periods. There was a raised threshold for admission after guideline implementation with 11/52 patients having mild exacerbations in 2006, compared to 21/36 in 2005. Duration of admission was less in the post-implementation group for equivalent exacerbation severity e.g. for moderate severity; 28 hours in 2005, 23 hours in 2006. Duration of bronchodilator therapy was shorter in 2006 and more likely to be given by spacer device earlier for equivalent levels of severity e.g. for moderate exacerbations, in 2006 the average length of salbutamol therapy was 18 hours with 12 hours by spacer device, in 2005 the average length of therapy was 25 hours with 3 hours by spacer. There was earlier initiation of oral corticosteroids; the average time to administration was 56 minutes in 2006 and 227 minutes in 2005. There was an improved documentation of asthma education in 2006 e.g. inhaler technique was reviewed in 37/52 in 2006, 21/35 in 2005 and better use of written action plans.
Language
en
ISSN
0332-3102
eISSN
ISBN
DOI
PMID
19873870