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

Abstract

To investigate real-life salbutamol use by children with asthma at home and compare it with their written asthma action plans (WAAPs). Multicentre, observational prospective study. Five tertiary care hospitals in France. 120 children aged 3-11 years with asthma. 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. 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. 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. 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. NCT04810169.