Note to pediatricians: Taper meds in kids with stable asthma
asthma: A study of how pediatricians prescribe asthma medications suggests that while most would readily increase a child’s medication if needed, many are reluctant to taper off drug use when less might be best. A report on the study, led by Johns Hopkins Children’s Center researchers, appears in the July issue of Pediatrics.
“Asthma medications can have serious, albeit infrequent, side effects, and while under-treatment is undeniably a big problem, not stepping down treatment when a child is doing well may be too,” says lead investigator Sande Okelo, M.D., an asthma specialist at Hopkins Children’s.
In the research, conducted among 310 pediatricians nationwide, 40 percent said they would not step down high-dose treatment even if a child’s symptoms were well controlled and infrequent.
“If a child is doing well and her symptoms are well under control, why not take that chance and see if a smaller dose would do the trick?” says senior investigator Gregory Diette, M.D., M.H.S., a lung specialist at Hopkins.
Beyond side effects, Okelo says, a failure by pediatricians to taper off drugs may also lead parents to do so on their own by skipping doses or decreasing them.
“Past research shows that when parents are concerned about side effects and their child is doing well, they may take action without a doctor’s approval,” Okelo says.
For the study, the pediatricians were asked to devise treatment plans using different patient scenarios, describing various elements, including whether a child had been hospitalized recently, how bothersome and frequent a child’s symptoms were, whether symptoms had recently intensified or lessened and whether the child had wheezing on a physical exam. Most doctors reported they would step up treatment in patients with:
keywords: asthma
If you enjoyed this post, please consider to leave a comment or subscribe to the feed and get future articles delivered to your feed reader.
Comments
No comments yet.
Leave a comment