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Updates in Pediatric Asthma

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Overview

Asthma is the most common chronic condition in children in the US, with an incidence of 9% (6.8 million individuals under the age of 18). It is more common in children from families living below the poverty threshold (13%) than families with higher incomes (8%). African-American children are more likely to have asthma (16%) than Hispanic (9%) or non-Hispanic white (8%) children. Asthma cannot be cured, but illness and deaths can be prevented with appropriate drug therapy.

The National Asthma Education and Prevention Program

(NAEPP) Expert Panel Report (EPR-3) guidelines for the Diagnosis and Management of Asthma are currently used as the standard of practice in the US, but have not been updated since 2007. An international guideline -- the Global Initiative for Asthma (GINA) global strategy for asthma management and prevention – was extensively revised in 2014, and was updated in 2015 to include current literature. GINA provides a comprehensive, integrated approach that is widely used to guide asthma management. Both the EPR-3 and GINA guidelines endorse the involvement of

pharmacists and nurse practitioners

in comprehensive asthma management strategies. GINA separates asthma patients into 2 age groups: 1) children 5 years of age and younger, and 2) adults, adolescents, and children age 6 and older. This article is focused solely on pediatric asthma, using the GINA age groupings and related recommendations. Children less than 6 years old are considered “young children” and those 6 to 17 years old will be referred to as “older children.” The outpatient management of pediatric asthma based on GINA strategies will be reviewed including the medications most commonly used for pediatric asthma.

The role of community providers in pediatric asthma management is multi-faceted and may include education, monitoring drug therapy, and equipping patients/families for self-management. The educational needs of patients and family include information about the disease and medications, regular review of proper inhaler and spacer technique, instruction about the use of peak flow meters, and recognition of triggers and symptoms.

Drug therapy

may be monitored through inquiries about effectiveness, side effects, and adherence to treatment. Self-management skills may include adopting asthma action plans, setting goals, avoiding triggers, and home management of exacerbations.

Details

Publication Date: 03/23/2016
Expiration Date: 03/23/2019
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Kelly J Wright, PharmD, BCACP, TTS is a clinical pharmacist at Primary One Health in Columbus, Ohio.

Expert Editorial Advisor: Brooke L. Gildon, PharmD, BCPS, AE-C

Disclosure Statement

Dr. Wright reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Review the clinical presentation, diagnostic considerations, and risk factors for pediatric asthma.
    2. Describe the goals of therapy and the stepwise approach to treatment. Discuss the appropriate use of reliever and controller medications.
    3. List the pharmacological classes of medications used for pediatric asthma. For each class, name the drugs(s), state their recommended doses (for young children and older children), and list their adverse effects.
    4. Counsel parents about potential solutions to asthma triggers and the use of spacers and peak flow meters if indicated for their child.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-16-003-H01-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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