Association between skin testing in the pediatric emergency department and adherence to follow-up in children with asthma.
BACKGROUND
Efforts to enroll inner-city asthmatic children into continuity care after a pediatric emergency department (PED) visit are frequently unsuccessful. Providing parents with documentation of their child's allergic status and how this can be used to tailor an asthma management plan may improve adherence to scheduled continuity appointments.


OBJECTIVE
To determine whether skin testing children during PED visits for wheezing and providing parents with skin test results improves adherence to follow-up visits.


METHODS
A convenience sample of children aged 2 to 12 years with asthma who presented to the PED with wheezing were eligible. Enrolled children were randomized to group 1 (no skin test) or group 2 (skin test). At discharge, both groups scheduled asthma clinic appointments for within 1 week. Children in group 2 underwent skin testing with standard allergens, and parents were given documentation of skin test results. Adherence was assessed by computer confirmation of the patient's asthma clinic visit.


RESULTS
Seventy-seven children were enrolled: 39 in group 1 and 38 in group 2. The mean age was 7 years; 69% had mild intermittent asthma. Twenty-four percent of children (9 of 38) in group 1 vs 46% (17 of 37) in group 2 were followed up in the asthma clinic (P < .05). Children in group 2 were 2.6 (95% confidence interval, 1.02-6.65) times more likely to keep appointments compared with children in group 1.


CONCLUSIONS
Parents who receive evidence in the PED of their child's allergic status and probable relationship to the child's asthma are more likely to adhere to scheduled continuity visits.
Scarfi
Catherine A
CA
Department of Pediatrics, Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, New York 10461, USA.
Cunningham
Sandra J
SJ
Wiznia
Andrew
A
Serebrisky
Denise
D
Crain
Ellen F
EF
D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000276:immunology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011368:Professional-Family Relations; D012882:Skin Tests
D000485:Allergens