Findings from a recent study can help you work with your clinician, like your doctor or nurse practitioner, to choose the best option for managing your child's mild persistent asthma.

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Asthma is a common illness that can make it hard to breathe. Asthma can range from mild to severe, depending on how often symptoms occur. Children with mild persistent asthma usually have symptoms two or more days each week, but not every day. These children may experience symptoms less often if their asthma is well-controlled.

Children and teens use different kinds of inhalers to help control their asthma symptoms. Inhalers are handheld devices that push medicine into a person’s lungs. The medicine is in the form of a mist or spray. A quick-relief inhaler is used when symptoms get worse, which may happen suddenly. This inhaler usually contains a medicine called albuterol. A control inhaler helps prevent asthma symptoms. It usually contains corticosteroids. This inhaler can keep daily symptoms from getting worse.

There are two main approaches for using a control inhaler:

➤ Daily use, as directed by the clinician. Children use their control inhaler every day, whether or not they have symptoms that day. Clinicians adjust the amount of medicine in the inhaler when necessary.

➤ Symptom-based, or as-needed, use. Children use their control inhaler only on days when they have symptoms and need to use their quick-relief inhaler. Children using this approach use less corticosteroid medicine overall.

The research team wanted to see if using a control inhaler as needed worked as well as using it every day for children and teens who have mild persistent asthma.

Daily use of the control inhaler may not work well if parents and children can’t visit the clinician regularly or if they often get care in the emergency room. Also, some families may prefer the as-needed approach because it doesn’t rely on repeated clinician visits. But as-needed use of the control inhaler may not work well if parents and children don’t recognize asthma flares when they happen.

Questions to Ask My Child's Clinician

You may want to talk with your clinician about which treatment approach—daily or as needed—would work best for your child. Your clinician can help you create an Asthma Action Plan that best fits your lifestyle and needs. Questions to ask your clinician might include:

➤ Is using a control inhaler only as needed, rather than daily, an option for my child?

➤ Is there anything about my child’s asthma that we should think about when choosing an approach to managing asthma?

➤ What else should we consider when making this choice?

➤ If we use the as-needed approach, how can we tell if it’s working well to control my child’s asthma?

Be sure that the treatment approach you choose with your clinician is written in your child’s Asthma Action Plan. If your child has asthma symptoms, the Asthma Action Plan will help other people in your child’s life, such as other family members, school nurses, and teachers, know how to treat your child.

Read more about this study at www.pcori.org/Sumino282

Download this Evidence Update

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Sources

^{© 2011–2021 Patient-Centered Outcomes Research Institute. “Comparing Two Ways to Manage Asthma in African American Children -- The ASIST Study.” Last Updated September 30, 2020. https://www.pcori.org/Sumino282}

^{Sumino K, Bacharier LB, Taylor J, et al. A Pragmatic Trial of Symptom-Based Inhaled Corticosteroid Use in African-American Children with Mild Asthma. J Allergy Clin Immunol In Practice. 2020; 8(1): 176-185 e2. https://doi.org/10.1016/j.jaip.2019.06.030}

^{The information in this publication is not intended to be a substitute for professional medical advice. This update summarizes findings from a PCORI research award to Kaiser Permanente Washington Health Research Institute.}