title: Factors associated with frequent emergency room attendance by asthma patients in Palestine.
abstract: METHODS
  The emergency room (ER) of Alia Governmental Hospital in Hebron city, in the southern part of the West Bank.
  
  
  OBJECTIVE
  To investigate the role of asthma severity, health services utilisation and medication use in frequent ER attendance for asthmatics in Palestine.
  
  
  METHODS
  A cross-sectional study using a previously developed questionnaire.
  
  
  RESULTS
  Of 121 asthma patients, 73.5% were frequent ER attendees during the previous year, with a mean 6.7 visits (standard error 0.75). Moderate/severe asthma and hospital admissions in the previous year due to asthma were the strongest predictors for frequent attendees (adjusted OR [aOR] 6.92, 95%CI 2.44-19.62 and 11.16, 95%CI 4.37-28, respectively). Frequent attendees reported more difficulties in using asthma inhalers compared to one-time ER attendees (aOR 2.49, 95%CI 1.04-5.99). Inhaled short-acting beta(2)-agonists were reported to be used regularly, on most days, by frequent attendees (>or=1 canister/month) compared to one-time attendees (aOR 4.4, 95%CI 1.28-15 and 4.05, 95%CI 1.33-12, respectively).
  
  
  CONCLUSIONS
  Lack of proper use of inhalers and an over-reliance on reliever therapy contributes to asthma morbidity in Palestine. We recommend an intervention programme at the professional and patient levels.
authors: Faculty of Public Health, Al Quds University, Jerusalem, Palestine. Hamzeh.Alzabadi@nancy.inserm.fr
authors: H
authors: H
authors: Al Zabadi
authors: N
authors: N
authors: El Sharif
mesh_terms: D001249:Asthma / Q000188:drug therapy; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D006760:Hospitalization; D006801:Humans; D009330:Nebulizers and Vaporizers