Does your child usually suffer from asthma in the fall?

If  your child was off, or on lower dosages, of asthma controller medicines over the summer, have they been resumed, yet? A review of kids' health insurance data presented earlier this week at an American College of Chest Physicians meeting (Chest 2008) found that the peak months for emergency room visits and hospitalizations are October and November, while medication use peaked in December.  Summer is the low season for seeking health care for asthma and use of asthma meds.  I agree with the strategy to restart controller medicines before predicted attacks occur, instead of waiting until one hits.

When I was working as a pediatric clinical pharmacist, September marked the beginning of my busy season for asthma education, and it would continue into the winter months. So, this trend is in line with what was reported in the study. Many of my patients' asthma attacks were triggered by weather changes, seasonal allergies, or a cold. Not taking medicine properly was another reason.  Here are some of my favorite teaching points: 

• Be consistent about the timing of the doses and don't stop medicines without consulting your child's doctor; 
• If the doctor says it's ok to stop or give lower doses during the summer, don't forget to ask when to restart them. Some children have attacks triggered by high humidity in the summertime, so it is possible that your child may need it all year round, especially if there are chronic exposures to other common triggers;
• Don't forget to refill prescriptions.  Many kids end up in the hospital because they run out of their inhalers;
• Make sure the correct technique is being used to give the medicines, especially inhalers. Ask your pharmacist, nurse, or doctor to show you;
  
• Understand how and why the medicines work and teach your child. For example, using the controller medicines during an acute asthma attack does not help; 
• Ask questions about your child's asthma, even if you, or someone you know, has asthma; and
• Oh, don't forget that flu annual flu shot!