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High SABA use in urban children increases asthma hospitalizations

Primary care providers should carefully monitor short-acting beta-2 agonist and controller medication use to improve asthma control and reduce hospitalizations among inner city children with asthma, according to study results.

“Overuse of (short-acting beta-2 agonist [SABA]) is associated with greater health care usage,” Arlene M. Butz, ScD, RN, CRNP, of Johns Hopkins University School of Medicine, and colleagues wrote. “A fivefold higher rate of hospitalization within the past 3 months and an almost threefold higher rate of having a prior ICU admission in children with high SABA use were noted compared with children with low to moderate SABA use.”

The researchers conducted an ongoing randomized controlled trial from August 2013 through October 2014 on 100 inner city children with persistent asthma to test the effectiveness of an ED and home-based environmental control intervention in children with multiple ED visits for asthma.

The use of SABAs was considered high; 27% of participants reporting daily use during the previous 2 weeks.

Children with high SABA use were almost six times more likely to be hospitalized (OR = 5.86; 95% CI, 1.56-22.08) for asthma within the past 3 months than children with low to moderate SABA use.

The researchers also wrote that providers should evaluate allergen sensitization and exposure as well as screen for secondhand smoke exposure in urban children.

There were some limitations to the study, including the use of pharmacy claims data, in assessing SABA use, according to the researchers.

“High SABA fills could reflect family sharing of medications and could have resulted in an overestimation of SABA canisters dispensed,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.