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Utilization trends of respiratory medication in premature infants discharged on home oxygen therapy
Author(s) -
White Heather,
Berenson Alice,
Mannan Javed,
Feldman Henry A.,
Rhein Lawrence
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24735
Subject(s) - medicine , bronchopulmonary dysplasia , discontinuation , oxygen therapy , pediatrics , medical prescription , neonatal intensive care unit , weaning , respiratory system , randomized controlled trial , gestational age , anesthesia , pregnancy , genetics , pharmacology , biology
Background Roughly half of all extremely preterm infants will be diagnosed with bronchopulmonary dysplasia (BPD), and a third will be discharged on home oxygen therapy (HOT). To date, there have been no studies that have examined the relationship between respiratory medication utilization in infants with BPD on HOT. Methods The recorded home oximetry trial was a multicenter, randomized trial comparing two home oxygen management strategies in premature infants. Infants were enrolled at first outpatient pulmonary or neonatal intensive care unit (NICU) follow‐up visit with a pulmonary component. Respiratory medication prescriptions and dosage were collected from time of enrollment through 6 months after HOT discontinuation. Patients were seen monthly while on HOT and at 1, 3, and 6 months after successful discontinuation. Results During protocol visits, 174 (89%) infants had respiratory medications documented. Respiratory medication use was higher at initial follow‐up visit compared with NICU discharge and decreased at the final 6‐month follow‐up visit. Infants who received inhaled steroids (IS) before weaning had mean HOT duration of 138 days (range: 24‐562 days); infants who received IS after weaning had shorter mean HOT duration (55 days, range: 21‐264). In time‐to‐event analysis the no IS group and the postwean group differed significantly ( χ 2 1 = 8.1; P = .004). NICU clinics gave a total of 35 prescriptions to 43 patients, an average of 0.8 per patient, while the pulmonary clinics gave 837 prescriptions to 153 patients, or 5.5 per patient ( P < .0001). Conclusion Respiratory prescribing patterns for infants on HOT are highly variable. Utilization of IS was not associated with shorter duration of HOT.