Periodic Use of Inhaled Steroids in Children With Mild Persistent Asthma: What Are Pediatricians Recommending?

Author:

Sawicki Gregory S.1,Smith Lauren2,Bokhour Barbara3,Gay Charlene4,Hohman Katherine H.4,Galbraith Alison A.4,Lieu Tracy A.5

Affiliation:

1. Harvard Pediatric Health Services Research Fellowship Program, Children's Hospital Boston, Boston,

2. Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston

3. Boston University School of Public Health, Boston, Center for Health Quality, Outcomes and Economic Research, ENRM Veterans Affairs Medical Center, Bedford, Massachusetts

4. Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston

5. Harvard Pediatric Health Services Research Fellowship Program, Children's Hospital Boston, Boston, Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, Division of General Pediatrics, Children's Hospital Boston

Abstract

Although asthma treatment guidelines recommend daily inhaled corticosteroid (ICS) use for all persistent asthma, pediatricians may recommend alternative treatment plans for children with mild persistent disease. The authors administered a survey of pediatricians to describe prescribing patterns for mild persistent asthma. More than 99% of providers agreed that periodic ICS could be effective for some asthma patients. Overall, 129/251 providers (51%) reported prescribing daily ICS to most patients with mild persistent asthma, whereas 78 (31%) reported recommending periodic ICS for most such patients. Providers with patient populations ≥ 25% black were significantly less likely to report prescribing daily ICS (odds ratio, 0.3; 95% confidence interval, 0.2-0.6) for mild persistent asthma. Further research is needed on the effectiveness of periodic ICS use for children with mild persistent asthma and on underlying reasons for differing provider practice patterns.

Publisher

SAGE Publications

Subject

Pediatrics, Perinatology and Child Health

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1. Treatment Decisions in Children with Asthma in a Real-Life Clinical Setting: The Swiss Paediatric Airway Cohort;The Journal of Allergy and Clinical Immunology: In Practice;2021-10

2. Not Breathing Easy: “Disarticulated Homework” in Asthma Management;Medical Anthropology Quarterly;2021-01-27

3. Is It Time to Admit Defeat on Patient Adherence?;The Journal of Allergy and Clinical Immunology: In Practice;2020-01

4. A Pragmatic Trial of Symptom-Based Inhaled Corticosteroid Use in African-American Children with Mild Asthma;The Journal of Allergy and Clinical Immunology: In Practice;2020-01

5. Analysis of the predicting factors of recurrent wheezing in infants;Italian Journal of Pediatrics;2019-01-29

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