title: Pulmonary function testing in the emergency department and medications prescribed at discharge: results of the Multinational Acute asthma Management, Burden, and Outcomes (MAMBO) study.
abstract: OBJECTIVE
  To evaluate asthma care in the emergency department (ED), including use of pulmonary function testing (PFT) and how patients are treated when discharged.
  
  
  METHODS
  Internet-based surveys were completed by 298 healthcare practitioners in seven countries on 1078 patients 15-70 years old with an acute asthma exacerbation.
  
  
  RESULTS
  Less than 60% of patients received guideline-recommended therapy with a bronchodilator, corticosteroid, and supplemental oxygen. Patients undergoing PFT had significantly more courses of asthma therapy (2.3 vs 1.7; p < 0.001), and received more medications (5.7 vs 3.9; p < 0.001). At discharge, 17.9% of patients did not receive a prescription asthma medication and 12.8% did not receive a physician referral. Men (p<0.022), patients with more severe disease (p<0.0001), and those seen by a pulmonologist (p<0.0001), were more likely to be treated.
  
  
  CONCLUSIONS
  Management of patients with acute asthma exacerbations diverged from guideline recommendations. Enhanced adherence to guidelines could lead to improved outcomes.
authors.affiliation: University of British Columbia, Vancouver General Hospital Division of Respiratory Medicine, The Lung Centre, Gordon and Leslie Diamond Health Care Centre, Vancouver, BC, Canada. markf@interchange.ubc.ca
authors.forename: J Mark
authors.initials: JM
authors.lastname: Fitzgerald
authors.forename: Paul M
authors.initials: PM
authors.lastname: O'Byrne
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: McFetridge
authors.forename: Dirk
authors.initials: D
authors.lastname: Demuth
authors.forename: Felicia C
authors.initials: FC
authors.lastname: Allen-Ramey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents