Study: Pediatric asthma care can improve with personalized assessment

By Allen Cone  |  March 2, 2018 at 2:29 PM
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March 2 (UPI) -- Improved personalized assessments could increase the accuracy of treatment and efficacy of medication for pediatric asthma patients discharged from hospitals, according to a new study.

Researchers improved care by asking six asthma control questions, according to a study published in the March issue of Hospital Pediatrics.

"The key to caring for pediatric asthma patients is that the most appropriate medication at the right dosage must be prescribed, and the child has to take their medication every day," Dr. Alexander Hogan, assistant professor in the Department of Pediatrics at the University of Connecticut School of Medicine said in a university release. Hogan led the study at The Children's Hospital at Montefiore in Bronx, N.Y., while a fellow.

Asthma is caused by airway inflammation and constriction due to various irritants. Some children with mild disease occasionally need a rescue inhaler, but others with persistent asthma need to use a daily controller medication, such as an inhaled corticosteroid, to decrease and possibly eliminate asthma attacks.

More than 136,000 pediatric hospitalizations occur annually, according to the Centers for Disease Control and Prevention, and 219 children under 18 died in 2015 from asthma, according to the CDC.

At the New York hospital, clinicians guided the patient's personalized care with streamlined patient care decision tools, an electronic medical record system and access to a mobile phone application.

The six questions asked of all patients pertained to the number of asthma symptoms per week, number of nighttime awakenings per month, number of inhaler uses for symptoms per week, the degree of asthma's interference with normal activity, the number of asthma exacerbations requiring oral corticosteroids during the previous year and how many doses per week have been missed from current controller therapy.

Each week in 2015-2016, the first five patients discharged were reviewed for documentation of the six asthma control questions and accuracy of the discharge controller therapy.

A total of 240 preintervention and 252 postintervention charts were reviewed by researchers, and in some weeks there were more than five patients each week.

The researchers found the appropriate controller therapy improved from 60 percent before intervention to 80 percent in the postintervention when the six questions were asked.

The frequency of medical personnel asking the questions also increased from 40 percent to 98 percent during the study.

"Our study findings show small changes truly do add up," Hogan said. "If you are concerned your child's asthma is not well controlled, it is imperative you raise these concerns with your pediatrician."

Hogan told UPI the study did not determine whether patients followed the advise of medical personnel. He also said that because the patients generally are on subsidized care, the inhalers were not a financial burden.

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