ASTHMA WATCH

Tutorial Educates on Proper Inhaler Use

A new Web-based tutorial is now available to educatepatients with lung disease about how to take their inhalationmedications correctly.

The American Association for Respiratory Care (AARC),which launched the free tutorial, said that using the wronginhaler during a respiratory attack could be deadly and recommendedthat patients place a large "X" on their rescuemedication so they can immediately identify the correctinhaler. Another issue for patients is knowing when theirinhalers have run out of medicine. There are 200 actuationsin an albuterol canister, and the FDA recommends keepingcount through a diary. The AARC also recommends purchasinga dose meter at the pharmacy to help track medications.

Whereas the asthma patient will use 2 inhalers, a typicalpatient with chronic obstructive pulmonary disease will use4 inhalers. Each medication works differently and needs tobe taken as prescribed to work properly. The tutorial can befound at www. YourLungHealth.org.

Caregivers' Mental Health ImpactsKids' Asthma Treatment

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

The current study analyzed how a caregiver's mentalhealth may impact a child's asthma treatment. The researchersassessed the psychiatric symptoms in 175 caregiversof children hospitalized for asthma. The study foundthat almost 27% of caregivers were currently experiencingdepression, while 20.6% were experiencing an anxiety disorder.Children whose caregivers scored high on 2 or moretests for mental health symptoms had been hospitalized64% more often for asthma, compared with those whosecaregivers scored lower. The findings also indicated thatchildren whose caregivers were depressed had moreimpromptu clinic visits, while children whose caregivershad 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 increaseawareness of anaphylaxis.

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

• Seek Support
• Allergen Identification and Avoidance
• Follow up for Specialty Care
• Epinephrine for Emergencies

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

New Tool Helps Pinpoint Acute Asthma Cases

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

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

Start Asthma Treatment Early

If emergency room physicians started patients with asthmaon maintenance medication when they arrived at thehospital, it might help prevent future flare-ups. Researchersmade the recommendation after evaluating a pediatricemergency department-based program designed to establisha new role for the emergency room physician.

For the study, reported in Pediatrics (December 2006), theresearchers provided 40 children with persistent asthmawith anti-inflammatory medications, and a letter summarizingthe treatment plan was faxed to the patient's primarycare physician the next day. It was the primary care physicians' responsibility to prescribe ongoing anti-inflammatorymedication. Of all the participants, 28 followed up with theirprimary care physician, and the anti-inflammatory medicationwas continued in 21 of them. Overall, one third of thepatients continued on a long-term anti-inflammatory medicationfollowing the emergency room visit.