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Are Asthma Medications and Management Related to Deaths From Asthma?

Citation

Abramson, MJ and Bailey, MJ and Couper, FJ and Driver, JS and Drummer, OH and Forbes, AB and McNeil, JJ and Walters, EH, Are Asthma Medications and Management Related to Deaths From Asthma?, American Journal of Respiratory and Critical Care Medicine, 163, (1) pp. 12-18. ISSN 1073-449X (2001) [Refereed Article]

DOI: doi:10.1164/ajrccm.163.1.9910042

Abstract

There is controversy about the role of β-agonists in asthma mortality, and the impact of asthma management plans remains unclear. We compared blood β-agonist levels in patients dying from asthma with those in controls, and estimated the risks associated with specific classes of medication and patterns of management. We identified 89 asthma deaths and recruited 322 patients presenting to hospitals with acute asthma. A questionnaire was administered to the next of kin in 51 cases, and to 202 controls. Blood drawn from 35 cases and 229 controls was assayed for salbutamol. Smoking, drinking, and family problems were significantly more likely among the cases of asthma death than among the controls. The two groups were reasonably well matched with regard to markers of chronic asthma severity. Cases of asthma death were significantly less likely than controls to use a peak flow meter. Written action plans were associated with a 70% reduction in the risk of death. Use of nebulized bronchodilators or oral steroids was significantly more likely in cases of asthma death. Mean blood salbutamol concentrations were 2.5 times higher in cases of asthma. The use of oral steroids for an attack of asthma reduced the risk of death by 90%. More widespread adoption of written asthma management plans, with less reliance on β-agonists and closer medical supervision, should reduce asthma mortality.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Walters, EH (Professor Haydn Walters)
ID Code:21835
Year Published:2001
Web of Science® Times Cited:140
Deposited By:Medicine (Discipline)
Deposited On:2001-08-01
Last Modified:2002-07-04
Downloads:0

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