MILD ASTHMA in children can be managed when symptoms occur by the use of two inhalers: a steroid and bronchodilator. A study conducted by a team from the Washington University School of Medicine in St. Louis, Missouri, USA, found that this new method is effective in controlling asthma when compared to the traditional method of daily steroid intake and bronchodilator use when symptoms occur.
The study comprised 206 children aged 6–17 years who had mild asthma and were controlling it with steroid medication. The participants were randomly assigned to two groups: the first group took a dose from the steroid inhaler when symptoms (such as coughing and wheezing) arose, along with the bronchodilator; while the second group took their outlined dose of the steroid inhaler daily, irrespective of any symptoms, and also took the bronchodilator in response to symptoms. The latter follows the standard recommendation by the guidelines presented by the Global Initiative for Asthma (GINA).
After 1 year, no differences were found between the groups regarding control of patient asthma. There were also no differences in results from breathing tests to measure lung function, or in emergency room visits that were attributable to asthma attacks. Children in the first group took 526 mg per month of the steroid, as opposed to 1,961 mg in the second. This research showed that this new approach can reduce the levels of steroids taken by the children by almost 75% each month.
Researcher Prof Kaharu Sumino, Washington University, discussed the findings: “Patients in the group that used both inhalers as needed used about one-fourth the steroid dose of the group that inhaled a prescribed daily amount. We also were pleased to see that the patients and families felt that they had more ownership over their asthma management when practicing as-needed treatment.”
Children and caregivers in the group that took the steroid inhaler as needed, rather than daily, reported feeling active management over their asthma care, as opposed to feelings of passively relying on instructions from their doctor. This gave them ownership and control over their disease. Sumino concluded: “Given the result of our study and others, primary care doctors may tell their patients with mild asthma that they have an alternative effective strategy other than taking the inhaled steroid every day, if they prefer not to do so.”