Seven percent of children in Utah have asthma, but a new study shows most parents and caregivers incorrectly administer their medication.
The study, conducted by Children's Hospital at Montefiore in New York City and published in the Journal of Asthma, found that only one of 169 caregivers accurately carried out 10 steps outlined in national guidelines as the appropriate method to deliver adequate medication for asthma management.
Education efforts and training of caregivers could help to improve outcomes, and reduce hospital admissions and healthcare costs.
"Asthma medication is frequently administered incorrectly," said Dr. Doug Jones, an immunologist at Rocky Mountain Allergy, Asthma and Immunology in Layton. "Often, this stems from little or no training provided to the patients or parents on the proper technique. Sometimes it may even be due to them being shown incorrectly how to use the medication."
This poor administration leads to a low concentration of the drug into the lungs, which, in turn, inadequately controls the disease, Jones said.
Every day 3,600 children miss school because of asthma and its complications, according to the study. Children with the disease most often depend on their caregivers to administer their medication through an inhaler. The most common approach is done by using a spacer, or chamber with a mask that holds the medication and is placed between the inhaler and the child's mouth.
Researchers surveyed and evaluated 169 caregivers of children ages 2 to 9 with persistent asthma whose doctor prescribed the inhaler on a daily basis. The caregivers monitored administration techniques using a 10-step checklist. If caregivers followed through with at least seven of these steps accurately, they were using the right technique. Six or fewer steps being used was deemed poor.
"As only one caregiver could do all steps accurately, and fewer than four percent were able to complete five essential steps, we believe that regular education efforts would be beneficial to caregivers and their children," said lead author Dr. Marina Reznik. "We also learned that caregivers whose children had been admitted for asthma in the past year were more likely to exhibit correct use, suggesting they had been retrained during the hospitalization and, as a result, were better able to perform the steps."
More than 90 percent of caregivers said they had received a verbal explanation of how to administer the medication, but only 54 percent were asked by a medical professional to demonstrate that they could actually do it themselves.
Jones said many different types of devices deliver asthma medications, and sometimes patients may get confused as to how to use one device versus another.
"It's so important for patients to understand what device to use, how to use it properly and when to use it," Jones said.
Jones said he is vigilant about teaching his patients and their caregivers about asthma and the proper way to treat it, and has certified educators on staff.
"I have found most people have an incorrect understanding of what asthma is, and they do not know why they are taking certain medications," Jones said. "There are many complexities and nuances to effectively diagnosing and treating asthma. It definitely matters who patients see."