COMMENTARY

Monthly Summaries of Nursing Research: December, 2008

January 05, 2009

December and August Asthma "Tune-up" Medication Management Visits May Improve Asthma Control in Children

The National Institute of Nursing Research (NINR) is part of the National Institutes of Health. NINR's federal research dollars support clinical and basic nursing research to establish the scientific base for the care of individuals across the life span. NINR's support extends to problems encountered by patients, families, and caregivers, and emphasizes the special needs of at-risk and underserved populations to reduce health disparities. NINR has a significant mission in research training and career development, supporting predoctoral and postdoctoral education for nurses and midcareer awards for doctorally prepared nurses.

Butz AM, Thompson RE, Tsoukleris MG, et al. Seasonal patterns of controller and rescue medication dispensed in underserved children with asthma. J Asthma. 2008;45:800-806.

Asthma is a major cause of childhood disability and a leading cause of pediatric emergency department visits in the United States. Seasonal patterns in symptom exacerbation and emergency department visits have been well documented. A multidisciplinary group of researchers explored whether similar temporal trends exist for asthma rescue and control medications. Longitudinal analyses were performed using pharmacy record data and health information data obtained by parent report over 12 months for children with persistent asthma who were 2 to 9 years of age and from predominantly black and low-income families.

Overall, significantly fewer prescription fills were obtained in the summer months with an acceleration of medication fills in September through December and an increase in early spring. Results of the analyses suggest that timing of asthma monitoring visits to occur before peak prescription fill months (August and December), for an asthma "tune-up," could potentially improve asthma control. During these primary care visits children could benefit from more intense monitoring of medication use including monitoring lung function, frequency of prescription refills, and assessment of medication device technique to ensure that an effective dose of medication is adequately delivered to the respiratory tract. Additionally, scheduling nonurgent asthma care visits at pre-peak prescription fill months can take advantage of "step down" during decreased symptom periods and when appropriate restart daily controller medications to "step up" prior to peak asthma periods.

Abstract

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