The reader will come to: • Understand current international paediatric asthma protocols and identify how SABA discharge/weaning plans are addressed across the USA, UK, Canada, Australia, and Singapore. • Recognise the evidence gaps and lack of RCTs supporting existing SABA weaning practices following acute asthma exacerbations in children. • Evaluate the risks associated with SABA overuse, including increased exacerbations, hospitalisations, mortality, and potential misinterpretation of weaning plans by caregivers. • Appreciate the need for evidence-based, standardised discharge protocols, including appropriate use of inhaled corticosteroids and improved caregiver education to optimise paediatric asthma outcomes. This scoping review examines the recommendations for short-acting beta-agonists (SABA) in discharge and weaning plans following acute asthma exacerbations in children. It focuses on SABA overprescription in discharge/weaning plans after acute asthma exacerbations and explores strategies to promote protocol-directed care. National and institutional protocols from the USA, UK, Australia, Canada, and Singapore between 2000 and 2025 were reviewed. Data on SABA weaning plan recommendations, initial dosage, frequency, duration, and caregiver instructions were extracted and analysed using descriptive statistics. Searches were conducted from December 2024 to August 2025. Significant variability in protocols was found, with no randomised controlled trials or systematic reviews supporting current SABA discharge/weaning practices, highlighting a lack of evidence-based recommendations. There is an urgent need for RCTs to guide safe SABA use. Improved patient education, access to inhaled corticosteroids, and evidence-based discharge plans are key to reducing SABA overuse and improving paediatric asthma outcomes.
Yujie et al. (Thu,) studied this question.