Compliance and myths regarding use of Metered Dose Inhaler amongst caregivers of children suffering with asthma
|
|
- Adam Hill
- 6 years ago
- Views:
Transcription
1 Compliance and myths regarding use of Metered Dose Inhaler amongst caregivers of children suffering with asthma Keywords Veena Ranaut, Sukhwinder Kaur, Sukhpal Kaur, Meenu Singh Abstract: Asthma is one of the most common respiratory disorders in children.poor compliance with Metered Dose Inhaler (MDI) is a major problem in pediatric asthma management especially the adolescence as there is shift in responsibility for asthma management from parents to teen patients. A number of misconceptions and wrong practices regarding use of inhalers are prevalent in India. These effect the treatment seeking behavior and compliance. The present study was aimed to assess compliance with treatment, indices in past two months and mythsregarding use of MDI amongst the children suffering with asthma and their care givers. Using purposive sampling technique, 100 diagnosed patients (new and old) between ages of 3-14 years were enrolled. A semi-structured interview schedule was used to gather information regarding socio-demographic profile of the subjects, compliance with treatment and myths regarding use of the inhalers. Each subject was interviewed personally. Out of total subjects, 29% were not taking inhaler regularly. More than half (60%) were having 1-5 or more no. of attacks of asthma and (53%) were absent from school for 1-10 days due to illness since last two months.fifty one percent had certain myths related to inhaler like regular use of inhaler develops habit, it causes dryness of nose and throat, affects the growth of a child, children become lethargy, and affects the intelligence level etc.3% of the caregivers restricted their children to eat Rajmah, kheer, milk & milk products. It was concluded that a number of misconceptions and wrong practices regarding use of inhalers are prevalent.various educational programmes on the management of asthma needs to be organized. Compliance, Indices of Asthma, Myths Metered Dose Inhaler (MDI) Correspondence at Mrs Veena Ranaut Clinical Instructor, Sister Nivedita Govt. College, IGMC Shimla (Himachal Pradesh) Introduction Asthma is the most common chronic childhood disease with one in eight children 1 suffering from asthma. About 38% of these children miss school once per week and 8% 2 miss school once per month every year. Inhalation therapy is the cornerstone for acute and long-term management of asthma. However, the impact of treatment on the disease morbidity and mortality depends Nursing and Midwifery Research Journal, Vol-10, No.1, January
2 to a large extent on appropriate delivery of drug to the lungs. Poor patient compliance with inhaled medication is a known cause of 3 morbidity and mortality in asthma. Various factors contributing to poor compliance include the route of administration (oral therapy is preferred to inhaled medication), frequency of dosing (once- or twice-daily regimens are preferred), medication effects (a slow onset of action and long duration on discontinuance have poor adherence rates) 4,5 and the risk or concern of side effects. A compliance rates of around 50% with regular preventive therapy has been reported in the 6,7 studies. A number of misconceptions and myths about the inhalation therapy prevail in India, like use of inhaler is dangerous; it damages lungs and heart, it is the last resort, costly, and habit forming; one's ailment is 8 exposed to all and it is difficult to use etc. These may affect the treatment seeking behavior and compliance. Another important cause of poor compliance may be inappropriate techniques of using inhalation devices. This may result in misuse or overdose of drugs and may lead to diminished response to therapy. The child may require repeated hospitalizations. In one of the studies only 17.4% asthmatic children who received inhalation therapy revealed good compliance with their medication regimens. No child demonstrated the correct 9 technique of using inhaler. Empowering people with asthma to take an active role in the management of their condition can result in more effective 10 treatment of the disease. For better control of asthma in children, parents should be actively involved in the process.there is need to explore their fears and concerns about asthma and its treatment. Majority of the deaths due to asthmatic attack are avoidable. There is a need to lay a greater emphasis on regular treatment with preventive therapy. However, patients will benefit from therapy if they take their treatment properly and regularly. The current study was carried out with the objective to assess the compliance with treatment and myths regarding use of MDI amongst the care givers of the children suffering with asthma. Material and methods The study was conducted in the asthma clinic of Advanced Pediatric Centre (APC), Post Graduate Institute of Medical education and Research, Chandigarh. The children with various disorders are admitted in APC. The centre has a separate OPD block. Asthma clinic is held on every Tuesday on 3rd floor, D block. Using purposive sampling technique, a total of 100 diagnosed patients (new and old),were included in the study. Diagnosis was confirmed from OPD card written by the treating physician. An inclusion criterion to select the subject was children between age of 3-14 years and their care givers of all ages who accompany the child. After reviewing the literature and with consultation of experts, a semi-structured interview schedule was developed. Tool was validated by expert in nursing and paediatrics. Information was obtained regarding sociodemographic profile of the subjects,their compliance with the treatment, myths regarding use of the inhalers and indices in Nursing and Midwifery Research Journal, Vol-10, No.1, January
3 the last two months. Open ended questions were used to gather the information regarding myths related to asthma and inhalation therapy and problems faced by subjects. Information regarding indices of asthma morbidity included the number of severe attacks, number of visits to emergency, number of admission to hospital, need of injections and absence from school due to illness. Ethical approval for the study was obtained from Institution Ethical Committee Informed consent was obtained from each subject. The participants were assured that the information obtained from them will be kept confidential and it will be used only for research purposes.the diagnosed patients and their caregivers were contacted personally by the investigator. They were interviewed in a separate room as per interview schedule after taking written conscent. Data was analysed using SPSS 17 version. Descriptive statistics was employed. Results Demographic profile of the children The mean age of the subjects was 7.7 ± 0.6 years with the range of 3-14 years. 27% of subjects were less than 5 years of age, 56% were between 5 to 10 years of age. Around three fourth (73%) subjects were male. All the children were studying in school. 46% were studying between nursery to 3rd standard and remaining 54% subjects th th were studying between 4 to 8 standard. 60 % subjects were suffering with asthma since last 1-5 years. Demographic profile of the caregivers Majority (90%) of the caregivers were in the age of years. Mean age of the caregivers were 36.2±1.9 years with the range of years. As far as education of caregivers is concerned, 28% were undermatric, 64% were undergraduates. 42% mothers were house-maker where as 32% were professionals. 44% fathers were professionals, and 33% were unskilled and cultivators. Monthly income of around one third (37%) caregivers were ranging from Rs. > ,000. Mean income of the family was Rs ±10196 with the range from Rs ,000. Compliance of the subjects with the use of MDI Figure-1 depicts that out of total 100 subjects, 68% subjects were complied with the treatment whereas 29% subjects had poor compliance with the treatment Compliance with treatment Non-compliance with treatment Newly diagnosed cases Compliance with treatment Non-compliance with treatment Newly diagnosed cases Figure-1: Compliance of subjects with Metered dose inhaler 3 Nursing and Midwifery Research Journal, Vol-10, No.1, January
4 Problems while using MDI Out of total subjects, one fourth (25%) subjects having problems in use of MDI. 10% were having co-ordination and actuation problem; 8% were having dry throat and dry cough during inhaling drugs and 7% subjects were feeling suffocation and irritation during using inhaler with spacer. Myths related to asthma and inhalation devices amongst the caregivers More than half (51 %) caregivers were having certain myths related to use of inhalers. 17.7% were of the opinion that using inhaler for long duration develops habit in children.15.7% thought that inhalers cause dryness of nose and throat. 13.7% caregivers had myths related to the growth of child. 13.7% had misconception that children become lethargy after taking inhalers. 11.8% were in favour that inhalers affect the intelligence of the children. 5.9% caregivers were having myths that children using inhaler could not live normal life and equal numbers restricted their children to eat Rajmah, kheer, milk & milk products as all these edible items exacerbated asthma. 7.8% were having opinion that inhalers are the last resort of treatment. (Table 1) Table : Myths related to use of inhalers N=100 Myths No 49 Yes 51 n(%) Inhaler are habit forming 9(17.7) It causes dryness of nose and throat 8(15.7) Inhaler affects the intelligence 6(11.8) Inhaler and spacer should be cleaned with hot water 4(7.8) Inhaler affects the physical activities of a child 4(7.8) It is last resort 4(7.8) Child becomes lethargy with the use of inhaler 4(7.8) Child could not live normal life without it 3(5.9) Inhaler stunt the child's growth 3(5.9) Asthma is exacerbated by consuming milk, cheese, butter, curd & lassi 3(5.9) It is dangerous 3(5.9) Nursing and Midwifery Research Journal, Vol-10, No.1, January
5 Indices of asthma morbidity in last two months Table 2 depicts that 40%subjects were having 1-2 attacks of asthma, 20% were having 3-5 attacks of asthma in the last two months,20 % subjects visited emergency 1-2 times whereas 9 % were hospitalized for 1-5 days. One- third of the subjects (33%) were absent from school for 1-4 days and 20% were absent for 5-10 days due to illness in last two months. Table 2 : Indices of asthma morbidity (in last two months) N=100 Sr. Indices of asthma No. mordibity 1. Numbers of attack No attack Emergency visits(in days) No visit Hospitalization(in days) No Hospitalization Absence from school (in days) Not absent 47 Discussion Management of asthma through inhalation route is the mainstay of treatment. The various advantages over the other route of drug therapy include rapid action of the drugs, less dose and no systemic side N 4 effects. However, to be effective, the inhalation devices should be used properly and regularly as prescribed. In the present study out of 100 subjects, 68% subjects were taking prescribed drugs regularly whereas 29% subjects were having poor compliance with inhaler therapy. As per the responses from the caregivers, the causes for poor compliance were the problems in the form of coughing, suffocation and irritation while using inhalers without spacer. The use of spacers helps overcome the problem of coordinating inspiration with 11 actuation. Cramer et al had reported that only 15% of patients were receiving inhaled treatment regularly. In India, a number of misconceptions and wrong practices regarding use of inhalers' are prevalent. These affect the treatment seeking behavior and compliance. In the current study, around half of the subjects (51%) had certain myths regarding use of MDI like regular use of inhaler develops habit, it causes dryness of nose and throat, affects the growth of child, children become lethargy, affects the intelligence level, cleanliness of inhaler and spacer with hot water, affects the daily activities of child and the child could not live normal life. Three percent of the caregivers restricted their children to eat Rajmah, kheer, milk & milk products as all these edible items exacerbated asthma. Certain myths as per 12 Bosley et el were asthma medicine is addictive, long use of inhaler will lose effectiveness and won't work when the child is really sick, the steroids used to treat asthma are the same as the steroids used by athletes to get bigger and stronger, child can stop taking medicine when he/ she feel good Nursing and Midwifery Research Journal, Vol-10, No.1, January
6 and don't have any symptoms or problems breathing, If child has asthma, he or she should not be allowed to play like other kids and shouldn't take gym class or play sports etc. It is important that one should take inhalation medications regularly but utmost important that the technique to take inhaler should be proper. If the patient do not take their inhaler properly, their disease could get worsen. However it has been observed that patients have lack of skill in using MDI. Inhalers if not taken regularly may result in misuse, overdose, or diminished response of the administered therapeutic drugs, or may even result in unnecessary and repeated hospitalization. Inappropriate inhalation technique is hazardous to the safety of children with asthma and unnecessarily increases costs resulting from unnecessary re-hospitalizations. 13 The ISAYA study confirmed that the inappropriate use of drugs is mainly responsible for failure to control asthma. This study found that 47% of persistent asthmatics that participated in the survey in Italy were using combination therapy that was inadequate for the severity level (too low a dosage of corticosteroids and/or inappropriate treatment), and that 64% of asthmatics were on an irregular treatment that should have been taken daily. The study confirmed that for each degree of severity, regularity of treatment was associated with better control of symptoms. As per the indices of asthma morbidity, in the present study, 40% subjects were having 1-2 attacks of asthma where as 20% were having 3-5 attacks of asthma in the last two months, 20 % subjects visited emergency 1-2 times and 9 % were hospitalized for 1-5 days. One- third of the subjects (33%) were absent from school for 1-4 days and 20% were absent for 5-10 days due to illness in last two months. The study 14 conducted by Ray revealed that the increase in morbidity of asthma is reflected in days lost from school, worsening quality of life, increased hospitalization rates, increased intensive care admission and increased emergency department visits. It has been suggested that the rise in cases of asthma indicates a tendency to over-diagnosed childhood asthma; how ever a study 15 conducted by Clark et al suggested that there is under treatment of asthma. It is found that risk of misusing inhalers is particularly high in children and more debilitated patients and brief verbal instruction on correct technique, with a physical demonstration, is effective when repeated over time and can improve clinical outcomes. As there are a lot of misconception and misinformation in general public regarding use of inhaler and cause of bronchial asthma, they keep on avoiding dietary and other items which in fact have no role to play in either the causation or management of bronchial asthma. The most likely cause may be lack of training programmes regarding use of the inhalers, poor compliance and lack of knowledge. There is need for continue reinforcement and supplement asthma management programme at short interval. This will help the children and their caregivers in relieving and decreasing myths. Nursing and Midwifery Research Journal, Vol-10, No.1, January
7 References 1. Liu AH. Allergy and asthma prevention. Allergy and asthma proceeding2001; 22 (6): Eichardson G, Eick S, Jones R.How is the indoor environment related to asthma? Literature Review. Journal of Advanced Nursing 2005; 52 (3): Brand P. Key issues in inhalation therapy in children. Current medical research and opinion 2005, 21 (s4): S27-S Ehrlich RI, Du Toit D, Jordaan E, Zwarenstein M, Potter P, Volmink JA, et al. Risk factors for child hood asthma and wheezing. Am J RespirCrit Care Med. 1996;154: Kelloway JS, Wyatt RA, Adlis SA. Comparison of patients' compliance with prescribed oral and inhaled asthma medications. Arch Intern Med. 1994;154: Tashkin DP. Multiple dose regimens. Chest. 1995;107(5 suppl):176s 82S. 7. Athavale AU, Doshi K, Singhal P, Shah A, Iyer R, Shah AC. Compliance vs guidelines in the treatment of asthma: need for a practical approach. Lung India 1999; 17: Coults JA, Gibson NA, Paton JY. Measuring compliance with inhaled medication in asthma. Arch Dis Child 1992; 67: Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. NHLBI/WHO Workshop Report. Bethesda, NIH Publication No Kaur S, Behera D, Gupta D, Verma SK. Evaluation of self-care manual on bronchial asthma. Indian Journal of Chest Diseases and Allied Sciences 2006; 48: Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed? A novel assessment technique.jama.1989;261(22): CM Bosley, JA Fosbury, GM Cochrane.The psychological factors associated with poor compliance with treatment in asthma. ERS Journals Ltd : P Navaratnam, HS Friedman, E Urdaneta the impact of adherence and disease control on resource use and charges in patients with mild asthma managed oninhaled corticosteroid agents 456 article view 2010;4: Ray N, Themer M, Fadillioglu B. Race. Incomeurban city and asthma hospitalization in California. Chest 1998; 113: Clark NM, Brown R, Joseph CLM, Anderson EW, Liu M, Valerio M, Gong M. Issue in identifying asthma and estimating prevalence in an urban school population. Journal of clinical epidemiology2002; 55: Nursing and Midwifery Research Journal, Vol-10, No.1, January
Meenu Singh, Joseph L. Mathew, Prabhjot Malhi, B.R. Srinivas and Lata Kumar
Comparison of Improvement in Quality of Life Score with Objective Parameters of Pulmonary Function in Indian Asthmatic Children Receiving Inhaled Corticosteroid Therapy Meenu Singh, Joseph L. Mathew, Prabhjot
More informationMyths and beliefs of long-term care providers towards starting inhaled medications in children with bronchial asthma
and beliefs of long-term care providers towards starting inhaled medications in children with bronchial asthma *N A W K Nettikumara 1, K A M K U N Malaviarachchi 2, Y C N Dissanayaka 3, U C Gunarathna
More informationOffice Asthma Care: Practical Elements of Asthma Management. Learning Objectives. Diagnosis
Office Asthma Care: Practical Elements of Asthma Management Pri-Med West Annual Conference March 29, 2014 Anaheim, CA Sande Okelo, MD, PhD, University of California Los Angeles sokelo@mednet.ucla.edu www.uclahealth.org/pedspulmonology
More informationInterventions to improve adherence to inhaled steroids for asthma. Respiratory department
Interventions to improve adherence to inhaled steroids for asthma Respiratory department Content Overview Research References Overview Asthma is a chronic breathing condition that affects more than 300
More informationClinical Practice Guideline: Asthma
Clinical Practice Guideline: Asthma INTRODUCTION A critical aspect of the diagnosis and management of asthma is the precise and periodic measurement of lung function both before and after bronchodilator
More informationChitra C. Nair et al. Int. Res. J. Pharm. 2014, 5 (5) INTERNATIONAL RESEARCH JOURNAL OF PHARMACY
INTERNATIONAL RESEARCH JOURNAL OF PHARMACY www.irjponline.com ISSN 2230 8407 Research Article EVALUATION OF THE KNOWLEDGE OF PATIENTS, COMPLIANCE TO TREATMENT AND THE IMPACT OF PATIENT EDUCATION ON ASTHMA:
More informationASTHMA POLICY KYABRAM P-12 COLLEGE
Asthma Policy ASTHMA POLICY KYABRAM P-12 COLLEGE THE VICTORIAN SCHOOLS ASTHMA POLICY 1. ASTHMA AWARENESS As asthma can affect up to one in five children and one in ten adults, it is important for teachers
More informationIn 2002, it was reported that 72 of 1000
REPORTS Aligning Patient Care and Asthma Treatment Guidelines Eric Cannon, PharmD Abstract This article describes how the National Asthma Education and Prevention Program Guidelines for the Diagnosis and
More informationWho Is at Risk for Asthma? Who develope asthma?
Keya Ghosh What is Asthma? Disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing.
More informationAssessment of prescribing patterns of drugs used in adult asthma patients at a tertiary care hospital.
International Journal of Current Research in Medical Sciences ISSN: 2454-5716 P-ISJN: A4372-3064, E -ISJN: A4372-3061 www.ijcrims.com Original Research Article Volume 3, Issue 6-2017 Assessment of prescribing
More informationOn completion of this chapter you should be able to: discuss the stepwise approach to the pharmacological management of asthma in children
7 Asthma Asthma is a common disease in children and its incidence has been increasing in recent years. Between 10-15% of children have been diagnosed with asthma. It is therefore a condition that pharmacists
More informationAsthma Medications: Information for Children and Families. What You Need to Know about Medicines for Asthma
Page 1 of 8 PED-ALL-005-1992 Asthma Medications: Information for Children and Families What You Need to Know about Medicines for Asthma What Medicines Are used to Treat Asthma? There are two kinds of medicines:
More informationHow far are we from adhering to national asthma guidelines: The awareness factor
Egyptian Journal of Ear, Nose, Throat and Allied Sciences (2013) 14, 1 6 Egyptian Society of Ear, Nose, Throat and Allied Sciences Egyptian Journal of Ear, Nose, Throat and Allied Sciences www.ejentas.com
More informationASTHMA IN THE PEDIATRIC POPULATION
ASTHMA IN THE PEDIATRIC POPULATION SEARCH Rotation 2 August 23, 2010 Objectives Define asthma as a chronic disease Discuss the morbidity of asthma in pediatrics Discuss a few things that a health center
More informationAsthma Tips for Teachers, Coaches and Parents
Asthma Tips for Teachers, Coaches and Parents I CAN control my asthma! Community Pediatric Asthma Service Updated June 9, 2015 Asthma Facts The most common chronic illness in children 10-15% of Canadian
More informationStudent Paper PHARMACY PRACTICE. Keywords: asthma, inhalers, patient education
Assessment of Asthma Inhaler Technique in Two Community Pharmacies Nicole Farabaugh, PharmD Candidate; Ashlee McMillan, PharmD, BCACP; and Gretchen Garofoli, PharmD, BCACP WVU School of Pharmacy Keywords:
More informationMinimum Competencies for Asthma Care in Schools: School Nurse
Minimum Competencies for Asthma Care in Schools: School Nurse Area I. Pathophysiology 1. Explain using simple language and appropriate educational aids the following concepts: a. Normal lung anatomy and
More informationConcurrent Use Of Metered Dose Inhalers Without Spacer And Dry Powder Inhalers By Asthmatic Children Adversely Affect Proper Inhalation Technique
ISPUB.COM The Internet Journal of Pediatrics and Neonatology Volume 13 Number 1 Concurrent Use Of Metered Dose Inhalers Without Spacer And Dry Powder Inhalers By Asthmatic Children Adversely Affect Proper
More informationKnowledge of Asthma in Mothers of Children Suffering from Wheezing Disorder
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/76 Knowledge of Asthma in Mothers of Children Suffering from Wheezing Disorder Gaytri Koley 1, K C Koley 2 1 Associate
More informationAsthma Management for the Athlete
Asthma Management for the Athlete Khanh Lai, MD Assistant Professor Division of Pediatric Pulmonary and Sleep Medicine University of Utah School of Medicine 2 nd Annual Sports Medicine Symposium: The Pediatric
More informationOutpatient Guideline for the Diagnosis and Management of Asthma
Outpatient Guideline for the Diagnosis and Management of Asthma Initial Visit Follow-Up Visits See page 2 Asthma Diagnosis See page 3 Classifying Asthma Severity and Initiating Treatment See pages 2 and
More informationPlease read this leaflet carefully before you start using Fluticasone Cipla Inhaler.
Inhaler 125 microgram and 250 microgram MDI Fluticasone propionate Consumer Medicine Information Please read this leaflet carefully before you start using Inhaler. What is in this leaflet This leaflet
More informationManagement of acute asthma in children in emergency department. Moderate asthma
152 Moderate asthma SpO2 92% No clinical features of severe asthma NB: If a patient has signs and symptoms across categories, always treat according to their most severe features agonist 2-10 puffs via
More informationStudy To Assess Factors Contributing To Compliance Of Aerosol Therapy In Bronchial Asthma.
ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 12 Number 1 Study To Assess Factors Contributing To Compliance Of Aerosol Therapy In Bronchial Asthma. B bhushan, G Gaude Citation B bhushan,
More informationAPPENDIX C: MATERIALS FOR STEP 5 DATA ANALYSIS EXERCISES
Appendix C: Materials for Step 5 Data Analysis Exercises C-73 APPENDIX C: MATERIALS FOR STEP 5 DATA ANALYSIS EXERCISES C-74 Appendix C: Materials for Step 5 Data Analysis Exercises APPENDIX C: MATERIALS
More informationDiagnosis, Treatment and Management of Asthma
Diagnosis, Treatment and Management of Asthma Asthma is a complex disorder characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness, and an underlying inflammation.
More informationAsthma Beliefs and Literacy in the Elderly. Melissa Martynenko, MPA, MPH ABLE Project Manager Mount Sinai School of Medicine
Beliefs and Literacy in the Elderly Melissa Martynenko, MPA, MPH ABLE Project Manager Mount Sinai School of Medicine Health Literacy Annual Research Conference Bethesda, MD October 22, 2012 Background:
More informationASTHMA EXACERBATIONS:
ASTHMA EXACERBATIONS: IDENTIFYING AND ADDRESSING THE ROOT CAUSES MARCH 20, 2017 Speakers Anna Flattau, MD, MSc, MS, Senior Assistant Vice President Chief Clinical Officer OneCity Health Services/NYC Health
More informationAsthma Management Policy
Asthma Management Policy Asthma is a chronic health condition affecting approximately 15% of children. It is one of the most common reasons for childhood admission to hospital. Community education and
More informationBronchodilator Delivery and Nebuliser Trials in Adults
Bronchodilator Delivery and Nebuliser Trials in Adults Acute Management Favour the use of MDI (+/- Spacer) If considering nebuliser Short term treatment Approx. < 3 weeks See optimisation of inhaled bronchodilators
More informationNational Asthma Educator Certification Board Detailed Content Outline
I. THE ASTHMA CONDITION 9 20 1 30 A. Pathophysiology 4 6 0 10 1. Teach an individual with asthma and their family using simple language by illustrating the following with appropriate educational aids a.
More informationProject 3dii: Expansion of the Home Environmental Asthma Management Program
1 Project 3dii: Expansion of the Home Environmental Asthma Management Program Asthma Primary Care Project Participation Opportunity Purpose 2 This Project Participation Opportunity is specifically targeted
More informationAsthma and COPD Awareness breathe with ease sm and Chronic Obstructive Pulmonary Disease
Asthma and COPD Awareness breathe with ease sm and Chronic Obstructive Pulmonary Disease Michigan Newsletter Spring 2012 Getting Rid of Mold There are many types of molds. Molds will not grow without water
More informationInformation for Patients. Inhaler devices for routine treatment of chronic asthma in older children (aged 5-15 years)
Information for Patients Inhaler devices for routine treatment of chronic asthma in older children (aged 5-15 years) March 2002 Further information Further information on NICE and the full guidance on
More informationHARRISON COUNTY SCHOOLS OFFICE OF HEALTH SERVICES 445 W. Main Street Clarksburg, WV (304) FAX (304)
HARRISON COUNTY SCHOOLS OFFICE OF HEALTH SERVICES 44 W. Main Street Clarksburg, WV 6 (4) 6-769 FAX (4) 6-769 Dear Parent, Date Please complete the enclosed forms and return them to your school nurse. This
More informationAsthma: Evaluate and Improve Your Practice
Potential Barriers and Suggested Ideas for Change Key Activity: Initial assessment and management Rationale: The history and physical examination obtained from the patient and family interviews form the
More informationRich Segal, R.Ph., Ph.D. Professor and Associate Dean University of Florida
Exploring Barriers to Medication Adherence and Strategies for Improving Adherence for Asthma Rich Segal, R.Ph., Ph.D. Professor and Associate Dean University of Florida Presentation Objectives Understand
More informationAsthma. Jill Waldron Respiratory Specialist Nurse
Asthma Jill Waldron Respiratory Specialist Nurse Asthma morbidity 15 20% of children In a class of c30 children likely to be 4-54 children with asthma In infancy more common in boys but becomes more common
More informationASTHMA CARE FOR CHILDREN BASKET OF CARE SUBCOMMITTEE Report to: Minnesota Department of Health. June 22, 2009
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp ASTHMA CARE FOR CHILDREN
More informationTips for Parents. I CAN control my asthma! Presented by the Community Pediatric Asthma Service January 2011
Tips for Parents I CAN control my asthma! Presented by the Community Pediatric Asthma Service January 2011 Asthma Facts The most common chronic illness in children 10-15% of Canadian children have asthma
More informationINTERNATIONAL JOURNAL OF PEDIATRIC NURSING CORRELATION BETWEEN NUTRITIONAL STATUS AND MEMORY AMONG SCHOOL CHILDREN
26 INTERNATIONAL JOURNAL OF PEDIATRIC NURSING e - ISSN XXXX-XXXX Print ISSN - XXXX-XXXX Journal homepage: www.mcmed.us/journal/ijpn CORRELATION BETWEEN NUTRITIONAL STATUS AND MEMORY AMONG SCHOOL CHILDREN
More informationTHE NELSON THOMLINSON SCHOOL
THE NELSON THOMLINSON SCHOOL ASTHMA POLICY Signed by Headmaster: Signed by Chair of Governors: Reviewed by Behaviour Safeguarding and Wellbeing Committee 15 November 2018 Next review November 2019 Background
More informationOxfordshire Asthma Guidelines. for use in schools and other child care settings
Oxfordshire Asthma Guidelines for use in schools and other child care settings This document is underpinned by the principles of the United Nations Convention on the rights of the child, in particular
More informationQuestionnaire Survey for Bronchial Asthma in Elderly Care Facilities
Kobe J. Med. Sci., Vol. 64, No. 5, pp. E174-E179, 2018 Questionnaire Survey for Bronchial Asthma in Elderly Care Facilities HARUKO SHINKE 1, HIROSHI KAMIRYO 1, KANOKO UMEZAWA 1, SUYA HORI 1, KYOSUKE NAKATA
More informationFlow of Talk. Need for ICON in Childhood Asthma. WISC : ICAAI Symposium Highlights of Airway Diseases 12/7/2012
/7/ WISC :. ICAAI Symposium Highlights of Airway Diseases Pediatric Asthma in India Dr.H. Paramesh MD, FAAP(USA), FIAP,FIAMS, FIAA, FCAAI Director. Pulmonologist, Environmentalist, Lakeside Hospital, Bangalore
More informationElements for a Public Summary
VI.2 Elements for a Public Summary Fluticasone propionate / formoterol fumarate are available in pressarised metered dose inhalers (pmdi) under the brand names Flutiform, and in breath actuated inhalers
More informationIJRSS Volume 2, Issue 3 ISSN:
CEMENT DUST EXPOSURE ON HUMAN HEALTH Dr. K. SHOBHA* VENNILA GOPAL** _ India is facing a serious double burden of disease. Most of the old infectious diseases like malaria, filariasis and kala-azar have
More informationAsthma and the competitive swimmer
Asthma and the competitive swimmer Introduction: One in seven children and one in 25 adults in Great Britain have asthma and the number is growing. Thus every swim squad or club will have a number of asthmatics
More informationGreen Week Planetary boundaries in the context of air quality: empowering actors to act, urgently
Green Week 2013 Planetary boundaries in the context of air quality: empowering actors to act, urgently Empowering the most vulnerable groups - How can you fight against air pollution? Air pollution and
More informationTreatment Adherence Among Low-Income Children With Asthma
Journal ofpediatric Psychology, Vol. 23, No. 6, 1998, 345-349 Treatment Adherence Among Low-Income Children With Asthma Marianne Celano, 1 PhD, Robert /. Geller, 1 MD, Keith M. Phillips, 1 MD, and Robin
More informationASTHMA What Keeps the Wheeze Away. Dr. Janice Bacon MPHCA Annual Conference June 2016
ASTHMA What Keeps the Wheeze Away Dr. Janice Bacon MPHCA Annual Conference June 2016 ASTHMA Objectives Understand the effects of Asthma on the Pediatric population Understand the effects of Asthma on the
More informationAssessment of respiratory outcome among patients with lower respiratory tract disorders
2018; 4(11): 196-200 ISSN Print: 2394-7500 ISSN Online: 2394-5869 Impact Factor: 5.2 IJAR 2018; 4(11): 196-200 www.allresearchjournal.com Received: 03-09-2018 Accepted: 04-10-2018 Surendran SR M.Sc (Medical
More informationDiagnosis, Assessment, Monitoring and Pharmacological Treatment of Asthma
Diagnosis, Assessment, Monitoring and Pharmacological Treatment of Asthma Magnitude of Asthma - India Delhi Childhood asthma: 10.9% Adults: 8% Other Cities 3 to 18% Chhabra SK et al Ann Allergy Asthma
More informationbreatherville.org. Medical Editors
800.878.4403 breatherville.org Medical Editors Martha Hogan, MD Clinical Associate Professor of Pediatrics Georgetown University Medical School Private practice in Springfield, VA James Kemp, MD Clinical
More informationOXEZE TURBUHALER formoterol fumarate dihydrate dry powder for oral inhalation
IMPORTANT: PLEASE READ PART III: CONSUMER INFORMATION OEZE TURBUHALER formoterol fumarate dihydrate dry powder for oral inhalation This leaflet is part III of a three-part Product Monograph published when
More informationThe burden of asthma on the US Healthcare system and for the State of Texas is enormous. The causes of asthma are multifactorial and well known.
The burden of asthma on the US Healthcare system and for the State of Texas is enormous. The causes of asthma are multifactorial and well known. There are also indications that rural counties have a higher
More informationCompliance in Chronic Obstructive Pulmonary Disease Patients Attending Pulmonary Medicine OPD in a Tertiary Care Hospital: Prospective study
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) E-ISSN: 2279-0853, p-issn: 2279-0861. Volume 7, Issue 6 (Mar.- Apr. 2013), PP 34-38 Compliance in Chronic Obstructive Pulmonary Disease Patients
More informationADULT ASTHMA GUIDE SUMMARY. This summary provides busy health professionals with key guidance for assessing and treating adult asthma.
ADULT ASTHMA GUIDE SUMMARY This summary provides busy health professionals with key guidance for assessing and treating adult asthma. Its source document Asthma and Respiratory Foundation NZ Adult Asthma
More informationJournal of Pharmaceutical and Scientific Innovation
Journal of Pharmaceutical and Scientific Innovation www.jpsionline.com Research Article STUDY OF ASTHMA QUALITY OF LIFE QUESTIONNAIRE: AN INSTRUMENT FOR REVIEWING ASTHMA HEALTH EDUCATION AND PROMOTION
More informationProcedure/ Care Plan for Domiciliary Care Workers/ Support Workers - Assisting a Service User to use an Inhaler (Adult)
Procedure/ Care Plan for Domiciliary Care Workers/ Support Workers - Assisting a Service User to use an Inhaler (Adult) CLINICAL GUIDELINES ID TAG Medicines Management Specific Title: Procedure: Assisting
More informationPATIENT INFORMATION Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet
PATIENT INFORMATION Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet What is COPD? COPD is a general term, which includes the conditions chronic asthma, chronic bronchitis and emphysema. It is due
More informationLast updated: March Asthma Policy
Last updated: March 2019 Asthma Policy Contents: Statement of intent 1. Background 2. Key roles and responsibilities 3. Asthma medicines 4. Emergency inhaler 5. Symptoms of an asthma attack 6. What to
More informationPEDIATRIC ASTHMA INPATIENT CARE MAP
DATE PATIENT PEDIATRIC ASTHMA INPATIENT CARE MAP DOB HSC NO. PHIN Approved by the Winnipeg Regional Health Authority This Care Map is to be used as a guideline and in no way replaces sound clinical judgment
More informationKey points within the SPAG2, relevant to an asthma management policy, specify that schools must:
ASTHMA MANAGEMENT Purpose This document includes information on the implementation and operation of a model policy for the best practice management of asthma in Victorian schools. It is recommended that
More informationbeclometasone 100 MDI 2 puffs twice a day (recently changed to non CFC (Clenil Modulite))
Case 1 Mr Thomson, a 32 year old asthmatic who is well known to you comes into your pharmacy. He is known to have a best peak flow of 640 L/min. He tells you that over the last few weeks he has been wakening
More informationAsthma Policy Asthma
Asthma Policy 2018-19 Asthma Asthma is a condition that affects small tubes (airways) that carry air in and out of the lungs. When a person with asthma comes into contact with something that irritates
More informationPharmacoeconomic Analysis of Asthma in Pediatric Patients in Tertiary Care Hospital in Kerala
Indian Journal of Pharmacy Practice Association of Pharmaceutical Teachers of India Pharmacoeconomic Analysis of Asthma in Pediatric Patients in Tertiary Care Hospital in Kerala Stejin J*, Kishor KV, Nandha
More informationFLIXOTIDE CFC-FREE INHALER and JUNIOR CFC-FREE INHALER ['PUFFER'] Fluticasone propionate Consumer Medicine Information
FLIXOTIDE CFC-FREE INHALER and JUNIOR CFC-FREE INHALER ['PUFFER'] Fluticasone propionate Consumer Medicine Information Please read this leaflet carefully before you start using Flixotide (CFC-free) Inhaler.
More informationWorld Journal of Pharmaceutical and Life Sciences WJPLS
wjpls, 2016, Vol. 2, Issue 3, 375-380 Research Article ISSN 2454-2229 Reddy. WJPLS www.wjpls.org SJIF Impact Factor: 3.347 A STUDY ON PREVALENCE OF PNEUMONIA IN PEDIATRIC PATIENTS P. Nishaandhini Reddy*,
More informationExpert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma Full Report 2007
Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma Full Report 2007 TARGET POPULATION Eligibility Inclusion Criterion Exclusion Criterion RECOMMENDATIONS Selecting Initial Therapy
More informationFrom Chronic Lung Disease of Infancy to Asthma
From Chronic Lung Disease of Infancy to Asthma Mollie V. Anderson, CPNP Certified Pediatric Nurse Practitioner Pediatric Lung Care Bon Secours Medical Group St. Mary s Hospital 1 Mollie V. Anderson, CPNP
More informationEFFECTIVENESS OF MASSAGE THERAPY ON RESPIRATORY STATUS AMONG TODDLERS WITH LOWER RESPIRATORY TRACT INFECTION
Original Article NUJHS Vol. 5, No.2, June 2015, ISSN 2249-7110 EFFECTIVENESS OF MASSAGE THERAPY ON RESPIRATORY STATUS AMONG TODDLERS WITH LOWER RESPIRATORY TRACT INFECTION Abstract : 1 2 3 Helen Martina
More informationAsthma With a Slight Chance of Anaphylaxis
Asthma With a Slight Chance of Anaphylaxis An Update for Alberta Oral Health Professionals Sept 25/13 Presented by Val Olson CRE Community Pediatric Asthma Service Air passes through the: Nose or mouth
More informationASTHMA INFORMATION SHEET
ASTHMA INFORMATION SHEET Name of student Name of parent/guardian School Year Grade Asthma Management Date or age of diagnosis Name of current physician Office number Please list ALL current medications,
More informationCOPD COPD. C - Chronic O - Obstructive P - Pulmonary D - Disease OBJECTIVES
COPD C - Chronic O - Obstructive P - Pulmonary D - Disease 1 OBJECTIVES Following this presentation the participant should be able to demonstrate understanding of chronic lung disease by successful completion
More informationPathway diagrams Annex F
Pathway diagrams Annex F Fig 1 Asthma: The patient journey Asthma is diagnosed Making the diagnosis of asthma Confirming the diagnosis may depend on history, response to treatment, measurement of airflow
More information2017 Chronic Respiratory. Program Evaluation. Our mission is to improve the health and quality of life of our members
2017 Chronic Respiratory Program Evaluation Our mission is to improve the health and quality of life of our members 2017 Chronic Respiratory Program Evaluation Program Title: Chronic Respiratory Program
More informationSOCIO-ECONOMIC BURDEN OF CHILDHOOD ASTHMA
SOCIO-ECONOMIC BURDEN OF CHILDHOOD ASTHMA A. Lal L. Kumar S. Malhotra ABSTRACT The socio-economic burden of childhood asthma has not been assessed in India. We interviewed parents of asthmatic 85 children
More informationEPSDT. EPSDT-Acute Visit & Well Visit EPSDT Documentation. Acute Visit & Well Visit L. Chana Spearmon, MD, FAAP Neighborhood Health Pediatrics
EPSDT Acute Visit & Well Visit L. Chana Spearmon, MD, FAAP Neighborhood Health Pediatrics EPSDT Documentation Comprehensive Health and Developmental History Screenings for Vision/Hearing Developmental
More informationRecommended Component: Assure Immediate Access to Medications as Prescribed
Recommended Component: Assure Immediate Access to Medications as Prescribed Students must have immediate access to all medications as approved by healthcare providers and parents, regardless of the availability
More informationProspective study to assess knowledge regarding wheezing disorders among mothers of children aged between 6 months to 10 years: hospital based study
International Journal of Contemporary Pediatrics Kumar N et al. Int J Contemp Pediatr. 2018 May;5(3):732-736 http://www.ijpediatrics.com pissn 2349-3283 eissn 2349-3291 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20181001
More informationFLIXOTIDE ACCUHALER Fluticasone propionate 50, 100, 250 micrograms per inhalation
FLIXOTIDE ACCUHALER Fluticasone propionate 50, 100, 250 micrograms per inhalation Consumer Medicine Information Please read this leaflet carefully before you start taking Flixotide What is in this leaflet?
More informationPathology of Asthma Epidemiology
Asthma A Presentation on Asthma Management and Prevention What Is Asthma? A chronic disease of the airways that may cause Wheezing Breathlessness Chest tightness Nighttime or early morning coughing Pathology
More informationOXEZE TURBUHALER formoterol fumarate dihydrate
IMPORTANT: PLEASE READ PART III: CONSUMER INFORMATION OEZE TURBUHALER formoterol fumarate dihydrate This leaflet is part III of a three-part Product Monograph published when OEZE TURBUHALER was approved
More informationSources. Taking Charge of Your Asthma. Asthma Action Plan (to be completed with your doctor) UnitedHealthcare Insurance Company
Asthma Action Plan (to be completed with your doctor) Green Zone: (80 to 00% of my personal best) Peak Flow between and (00% = personal best) You can do all the things you usually do. Your asthma medicine
More informationPublic Dissemination
1. THE ASTHMA CONDITION 9 18 3 30 A. Pathophysiology 4 6 0 10 1. Teach an individual with asthma and their family using simple language by illustrating the following with appropriate educational aids a.
More informationAsthma. If an Ambulance is required - call immediately - do not delay. H & A Training PL RTO No:90871
Asthma is a reversible breathing problem caused from sudden or progressive narrowing and spasming of the smaller airways and includes mucus production, which interferes with oxygen exchange. People who
More informationEarly Teen Interview
I. STUDY NUMBER II. EVENT II. TODAY S DATE / / III. RA INITIALS IV. SITE 1 KENMORE 2 HOME 9 OTHER Early Teen Interview Okay, great. So, let s start the interview. I d like to begin by stressing that there
More informationAsthma Policy February 2014
Asthma Policy February 2014 Asthma Management Plan It is the intention of PCW Melbourne to provide, as far as practicable, a safe and supportive environment in which students at risk of asthma can participate
More informationASTHMA POLICY PURPOSE POLICY STATEMENT 1. VALUES 2. SCOPE 3. BACKGROUND AND LEGISLATION
ASTHMA POLICY This policy was written in consultation with The Asthma Foundation of Victoria. The Foundation s Asthma & the Child in Care Model Policy has been incorporated into this policy by KPV. For
More informationAsthma Policy. Hallbrook Primary School
Asthma Policy Hallbrook Primary School Contents: Statement of intent 1. Background 2. Key roles and responsibilities 3. Asthma medicines 4. Emergency inhaler 5. Symptoms of an asthma attack 6. What to
More informationSmell / Taste/ Color. Select the Source. Drinking water. Bathing. Outdoor water use. Have you digested, inhaled or touched the object/material?
Decision Tree for Exposure Exposed Not Exposed No Action required Noise / High Speck Smell / Taste Visual High CATTfish Nuisance Reading Health & Wellness EHP lending library Page 2 Page 3 Page 4 Page
More informationTHE ROLE OF INDOOR ALLERGEN SENSITIZATION AND EXPOSURE IN CAUSING MORBIDITY IN WOMEN WITH ASTHMA
Online Supplement for: THE ROLE OF INDOOR ALLERGEN SENSITIZATION AND EXPOSURE IN CAUSING MORBIDITY IN WOMEN WITH ASTHMA METHODS More Complete Description of Study Subjects This study involves the mothers
More informationAsthma Management Updates: A Focus on Long-acting Muscarinic Antagonists and Intermittent Inhaled Corticosteroid Dosing
Asthma Management Updates: A Focus on Long-acting Muscarinic Antagonists and Intermittent Inhaled Corticosteroid Dosing Diana M. Sobieraj, PharmD, BCPS Assistant Professor University of Connecticut School
More informationPatient adherence to inhaled therapy A clinical perspective. Nicolas Roche Cochin, Site Val de Grâce University Paris Descartes, Paris, France
Patient adherence to inhaled therapy A clinical perspective Nicolas Roche Cochin, Site Val de Grâce University Paris Descartes, Paris, France 1 Disclosures Aerocrine Almirall AstraZeneca Boehringer Ingelheim
More informationHOLY FAMILY CATHOLIC SCHOOL MEDICATION AND ASTHMA POLICY
HOLY FAMILY CATHOLIC SCHOOL MEDICATION AND ASTHMA POLICY Policy Statement - We would ask parents to request that their doctor, wherever possible, prescribe medication, which can be taken outside the school
More informationWe are looking forward to meeting with you and assisting in your cardiac care. Thank you, Metropolitan Heart and Vascular Institute.
Thank you for scheduling an appointment at Metropolitan Heart and Vascular Institute. We are looking forward to meeting you. Enclosed are our patient registration forms. Please complete these forms to
More informationAsthma and COPD Awareness breathe with ease sm and Chronic Obstructive Pulmonary Disease
Asthma and COPD Awareness breathe with ease sm and Chronic Obstructive Pulmonary Disease Medicare Newsletter Spring 2012 Getting Rid of Mold There are many types of molds. Molds will not grow without water
More informationUsing Big Data to Prevent Infections
Using Big Data to Prevent Infections A thought paper by Scalable Health Big Data Analytics Reduces Infections in Hospitals Healthcare Associated Infections (HAIs) are developed while patients are receiving
More information