Pharmacy Times

ASTHMA WATCH

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Tutorial Educates on Proper Inhaler Use

A new Web-based tutorial is now available to educate patients with lung disease about how to take their inhalation medications correctly.

The American Association for Respiratory Care (AARC), which launched the free tutorial, said that using the wrong inhaler during a respiratory attack could be deadly and recommended that patients place a large "X" on their rescue medication so they can immediately identify the correct inhaler. Another issue for patients is knowing when their inhalers have run out of medicine. There are 200 actuations in an albuterol canister, and the FDA recommends keeping count through a diary. The AARC also recommends purchasing a dose meter at the pharmacy to help track medications.

Whereas the asthma patient will use 2 inhalers, a typical patient with chronic obstructive pulmonary disease will use 4 inhalers. Each medication works differently and needs to be taken as prescribed to work properly. The tutorial can be found at www. YourLungHealth.org.

Caregivers' Mental Health Impacts Kids' Asthma Treatment

Asthmatic children whose caregivers suffer from mental health problems are more likely to be hospitalized, according to a study reported in Pediatrics (December 2006).

The current study analyzed how a caregiver's mental health may impact a child's asthma treatment. The researchers assessed the psychiatric symptoms in 175 caregivers of children hospitalized for asthma. The study found that almost 27% of caregivers were currently experiencing depression, while 20.6% were experiencing an anxiety disorder. Children whose caregivers scored high on 2 or more tests for mental health symptoms had been hospitalized 64% more often for asthma, compared with those whose caregivers scored lower. The findings also indicated that children whose caregivers were depressed had more impromptu clinic visits, while children whose caregivers had an anxiety disorder were hospitalized more often.

Be S.A.F.E. Campaign Focuses on Anaphylaxis

The American College of Allergy, Asthma, and Immunology (ACAAI) and the American College of Emergency Physicians (ACEP) have launched the Be S.A.F.E. campaign to increase awareness of anaphylaxis.

A panel of allergists and emergency physicians recommended the creation of a quick reference card for emergency physicians. The card provides information about anaphylaxis diagnosis, duration of patient observation, and suggested physician and patient resources. It also includes the S.A.F.E. system:

The reference card and additional information about the Be S.A.F.E. campaign can be found in the Health Professionals section of the ACAAI Web site at www.acaai.org.

New Tool Helps Pinpoint Acute Asthma Cases

The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens Risk Score may help improve the care of patients with asthma and reduce costs. The new clinical tool determines the hardest-to-treat cases by evaluating factors such as the patient's age, weight, smoking status, medical history, medications and breathing, and exercise tests. The early intervention tool is useful for assessing the possibility of asthma- related hospitalization or emergency room visits.

During the 3-year study, the researchers collected data and assigned scores ranging from 0 to 18 to about 2821 patients. The researchers found that patients with a moderate risk score of 5 to 7 points had a 3.5-fold increased risk of requiring hospital treatment. A score of 8 points or more showed a 12-fold higher risk, compared with patients with a low score of 0 to 4 points. (The findings were reported in the December 2006 issue of the European Respiratory Journal.)

Start Asthma Treatment Early

If emergency room physicians started patients with asthma on maintenance medication when they arrived at the hospital, it might help prevent future flare-ups. Researchers made the recommendation after evaluating a pediatric emergency department-based program designed to establish a new role for the emergency room physician.

For the study, reported in Pediatrics (December 2006), the researchers provided 40 children with persistent asthma with anti-inflammatory medications, and a letter summarizing the treatment plan was faxed to the patient's primary care physician the next day. It was the primary care physicians' responsibility to prescribe ongoing anti-inflammatory medication. Of all the participants, 28 followed up with their primary care physician, and the anti-inflammatory medication was continued in 21 of them. Overall, one third of the patients continued on a long-term anti-inflammatory medication following the emergency room visit.