Inhaled corticosteroids for asthma: are ED visits a missed opportunity for prevention?
Inhaled corticosteroids are effective but underused. This study evaluated the outpatient management of emergency department (ED) patients presenting with acute asthma and the relation of inhaled corticosteroid use to the patient's primary care provider (PCP) status. ED patients were interviewed by the hospital's asthma education program staff about their asthma. Overall, 85% (101 of 119) of asthmatics reported having a PCP. Although patients with a PCP and patients without a PCP both were using inhaled beta-agonists (93% v 89%, respectively; P = .54), patients without a PCP were less likely to be using inhaled corticosteroids (49% v 11%, P = .003). Controlling for age, acute asthma severity, and asthma hospitalizations during the past year, PCP status remained a significant predictor of inhaled corticosteroid use (odds ratio = 5.6; 95% confidence interval 1.1 to 27). Even among ED patients with a PCP, inhaled corticosteroids appear to be underused. ED asthma visits present an opportunity to initiate preventive measures such as inhaled corticosteroid use.
Singh
A K
AK
Department of Emergency Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston 02114, USA.
Woodruff
P G
PG
Ritz
R H
RH
Mitchell
D
D
Camargo
C A
CA
D000208:Acute Disease; D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000517:prevention & control; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care; D012648:Self Care
D000305:Adrenal Cortex Hormones