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Treatment patterns for pediatric asthma prior to and after emergency department events

David A Stempel1, Trent P McLaughlin, Richard H Stanford

  • 1Infomed Northwest, Bellevue, Washington, USA. econmed@msn.com

Pediatric Pulmonology
|July 13, 2005
PubMed

Insights

Pediatric asthma patients heavily rely on rescue inhalers. Emergency department visits for asthma lead to only a temporary increase in controller medication use, highlighting a need for better asthma management in children.

Area of Science:

  • Pediatric Pulmonology
  • Health Services Research
  • Pharmacotherapy

Background:

  • Asthma affects millions of children annually, with a significant burden on emergency departments (EDs).
  • Understanding treatment patterns is crucial for improving pediatric asthma care and reducing ED utilization.

Purpose of the Study:

  • To describe asthma treatment patterns in children during the year preceding and two months following an asthma-related ED event.
  • To evaluate the impact of ED visits on the utilization of controller medications versus rescue inhalers.

Main Methods:

  • Retrospective observational study using administrative claims data from a large US managed-care database.
  • Inclusion criteria: children aged 1-17 with at least one asthma-related ED visit in 2001, with 12 months pre- and 2 months post-event data.
  • Analysis of prescription dispensing patterns for inhaled corticosteroids (ICS), oral corticosteroids (OCS), and short-acting beta-agonists (SABAs).

Main Results:

  • 5,501 pediatric asthma ED admissions were identified.
  • In the year prior to ED visits, only 19.4% of children received ICS, while 58.3% received SABAs, with a high ratio of SABA to ICS dispensing.
  • Following ED events, ICS and OCS prescriptions increased significantly in the first month but returned to near baseline levels by the second month.

Conclusions:

  • Children with asthma exhibit a strong dependence on short-acting beta-agonists (rescue inhalers).
  • Asthma-related ED events trigger only a short-lived increase in controller medication prescribing.
  • Current treatment patterns suggest a need for enhanced asthma control strategies in pediatric populations to prevent recurrent ED visits.

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