Research backs parent-led treatment with asthma drug

Prednisolone treatment initiated by parents can reduce acute asthma symptoms in schoolchildren and cut use of care resources, research suggests.

Asthma symptoms were improved when children's parents initiated oral prednisolone treatment (Photograph: SPL)
Asthma symptoms were improved when children's parents initiated oral prednisolone treatment (Photograph: SPL)

Researchers at Geelong Hospital in Australia examined the effect of parent-initiated oral prednisolone treatment on acute asthma in 230 children aged five to 12 years with a history of recurrent asthma.

Previous studies failed to find a benefit associated with parent-initiated oral corticosteroid treatment. But because asthma is a leading cause of hospital admission, the authors saw a clear need to reduce burden on health resources.

In a three-year study the researchers assessed children's daytime and night-time symptoms using a scoring diary.

In total, 308 episodes requiring intervention occurred and were treated with either a short course of oral prednisolone 1mg/kg daily or a placebo.

Children given prednisolone showed a 15 per cent reduction in daytime symptom score compared with those treated with placebo. There was also a 16 per cent reduction in night-time symptom score for children given prednisolone, as well as reduced risk of healthcare resources use and reduced school absenteeism.

Lead researcher Dr Peter Vuillermin and colleagues wrote: 'From a health resource viewpoint, the use of parent-initiated oral corticosteroids is cheap and seems to be associated with an important reduction in health resource use, which is costly.'

However, potential side-effects of repeated courses include effects on behaviour, adrenal function and reduced adult height in children with asthma.

The authors concluded: 'The modest benefits of this strategy must be balanced against potential side-effects of repeated courses of an oral corticosteroid.'

BMJ Online 2010.

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