Home use of short-acting beta agonists by children with asthma: a multicentre digital prospective study.

Abstract

Objective: To investigate real-life salbutamol use by children with asthma at home and compare it with their written asthma action plans (WAAPs).

Design: Multicentre, observational prospective study.

Setting: Five tertiary care hospitals in France.

Patients: 120 children aged 3-11 years with asthma.

Interventions: Parents used a smartphone application connected to a smart inhaler via Bluetooth to record salbutamol use and answer questionnaires about their child's asthma symptoms over 6 months.

Main outcome measures: The primary outcome was the median number of salbutamol puffs used in the first 2 hours after an asthma symptom occurred, depending on symptom type. Secondary outcomes included how families operationalised WAAP instructions and the proportion who administered more or less salbutamol than prescribed.

Results: 43 families used the smart inhaler for asthma symptoms, recording 124 episodes of salbutamol use. The median number of puffs used in the first 2 hours was 3 (IQR 2-4, range 1-26), varying between 2 and 4 depending on the initial symptom type. The number of puffs used did not differ significantly between episodes with and without symptom resolution. 18 (42%) families used a number of salbutamol puffs similar to that in their WAAP, while 21 (49%) used fewer and only 4 (9%) used more.

Conclusions: Families typically use 2-4 puffs of salbutamol in the first 2 hours after an asthma symptom. Adjusting WAAPs to start with 2-4 puffs of salbutamol, to be repeated if necessary, would be more in line with family practice, and effective in most situations.

Trial registration number: NCT04810169.