While most doctors give kids two inhalers -- one for on the spot treatment and one that works to prevent symptoms over the long term -- this new study suggests that taking both inhalers as symptoms arise could be a better alternative to persistent medication use.
“We were pleased to find that as-needed treatment based on symptoms can deliver similar asthma control with less medication,” said researcher Dr. Kaharu Sumino. “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.”
The case for as-needed medications
To see how taking asthma medications as needed affected kids differently than staying on the medication over the long-term, the researchers had over 200 African American children, who are disproportionately affected by asthma, participate in the study.
The participants, all between the ages of 6 and 17, were divided into two groups: one that followed the more traditional course of treatment, which involved taking a prescribed dose of a steroid daily regardless of symptoms, in addition to a rescue inhaler as symptoms persist; and another group that took both the steroid and the rescue inhaler only when symptoms arose.
While asthma symptoms and lung function were no better or worse for either group, the researchers did note one major takeaway from the study: the children taking their inhalers only as needed were using less medication over the long term.
Steroids are beneficial in treating asthma symptoms, both on the spot and for prolonged treatment, but they do come with a number of side effects, which can be worrisome for parents. However, in taking the inhalers only as needed, the children were still able to control their asthma and dramatically reduce how much of the steroid they took on a regular basis -- which lowered the associated costs of the medication.
“This as-needed steroid plus rescue albuterol strategy is now recommended in the Global Initiative for Asthma guidelines as one of the options for the treatment of mild asthma,” said Dr. Sumino. “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.”