Asthma is the most common chronic disease in children and a major cause of morbidity and increased health care expenditures nationally (Adams, et al., 2001). For children, asthma is one of the most frequent reasons for admission to hospitals (McCormick? , et al., 1999). Silber, et al. (2003) noted that there are approximately 200,000 admissions for childhood asthma in the United States annually, representing more than $3 billion dollars in healthcare costs. Under-treatment and/or inappropriate treatment of asthma are recognized as major contributors to asthma morbidity and mortality. Guidelines for the diagnosis and management of asthma in children developed by the National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung and Blood Institute (NHLBI), as well as by the American Academy of Pediatrics (AAP), recommend the use of relievers to gain control of acute asthma exacerbation and reduce severity as quickly as possible, with step down medication to the least medication necessary to maintain control. However, there is evidence that these guidelines are not followed uniformly. For example, Crain, et al. (1995) found that fewer than half of hospital emergency department survey respondents had heard of the NHLBI guidelines and that there was variation in the use of relievers. Administration of appropriate medication therapy is under the direct control of the care provider.

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• Guidelines for the Diagnosis and Management of Asthma (2002)
• Asthma Management Model System
• National Asthma Education and Prevention Program
• American Academy of Pediatrics

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• Adams RJ, Fuhlbrigge A, Finkelstein JA, Lozano P, Livingston JM, Weiss KB, and Weiss ST (2001). Use of Inhaled Anti-inflammatory Medication in Children with Asthma in Managed Care Settings. Archives of Pediatrics and Adolescent Medicine, 155, 501-507.
• Clinical Practice Guidelines of the American Academy of Pediatrics: A Compendium of Evidence-Based Research for Pediatric Practice. American Academy of Pediatrics, 1999.
• Crain EF, Weiss KB and Fagan MJ (1995). Pediatric Asthma Care in U.S. Emergency Departments. Archives of Pediatric and Adolescent Medicine. 149, 893-901.
• Gross KM, Ponte CD (1998). New Strategies in the Medical Management of Asthma. American Family Physician. 58:1 http://www.aafp.org/
• McCormick? MC, Kass B, Elixhauser A, Thompson J and Simpson L (2000). Annual Report on Access to and Utilization of Health Care for Children and Youth in the United States – 1999. Pediatrics, 105:1, 219-230.
• Silber JH, Rosenbaum PR, Even-Shoshan O, Shabbout M, Zhang X, Bradlow ET, and Marsh RR (2003). Length of Stay, Conditional Length of Stay, and Prolonged Stay in Pediatric Asthma. Health Services Research, 38: 3, 867-886.
• Guidelines for the Diagnosis and Management of Asthma (2002).http://www.nhlbi.nih.gov/guidelines/asthma/index.htm
• Asthma Management Model System, http://www.nhlbisupport.com/asthma/index.html
• National Asthma Education and Prevention Program, http://www.nhlbi.nih.gov/about/naepp/index.htm

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