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Poor asthma education and medication compliance are associated with increased emergency department visits by
Saleh Al-Muhsen1, Nour Horanieh2, Said Dulgom2
1Prince Naif Center for Immunology Research and Asthma Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia ; Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Frequent pediatric Emergency Department (ED) visits for asthma are linked to poor patient education and medication misuse. Improving asthma education and adherence can reduce unnecessary ED use.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Health Education
Background:
- Acute asthma exacerbations are a primary reason for pediatric Emergency Department (ED) visits.
- Psychosocial, behavioral, and educational factors contribute to recurrent ED visits for pediatric asthma.
- Assessing the justification for frequent ED visits in asthmatic children is crucial.
Purpose of the Study:
- To identify risk factors associated with Emergency Department (ED) visits in children with asthma.
- To investigate the underlying reasons for frequent ED utilization by pediatric asthma patients.
Main Methods:
- A cross-sectional study involving 297 asthmatic children aged 1-17 years.
- Data collection occurred during visits to ED facilities at two major hospitals.
- Information gathered included patient demographics and reasons for ED visits.
Main Results:
- Asthmatic patients averaged 3.9 (±3.2) ED visits annually.
- Inadequately controlled asthma was present in 60.3% of patients; 56.4% lacked asthma education.
- Convenience (48.2%) and immediate attention (38.4%) were key reasons for ED visits, alongside misconceptions about ED efficacy.
Conclusions:
- Most pediatric asthma patients exhibit poor disease knowledge and improper medication use, indicating ineffective management plans.
- Frequent, potentially unnecessary ED visits are associated with inadequate asthma and medication education.
- Systemic deficiencies in directing patients to appropriate care necessitate improved patient/guardian education on asthma management and medication compliance.
Background:
Acute exacerbations of bronchial asthma remain a major cause of frequent Emergency Department (ED) visits by pediatric patients. However, other factors including psychosocial, behavioural and educational, are also reportedly associated with repetitive ED visits. Therefore, it is necessary to determine whether such visits are justifiable.
Objective:
The objective of this cross-sectional study was to identify risk factors associated with visits to ED by asthmatic children.
Methods:
Asthmatic children (n = 297) between 1-17 years old were recruited and information collected at the time of visiting an ED facility at two major hospitals.
Results:
Asthmatic patients visited the ED 3.9 3.2 times-per-year, on average. Inadequately controlled asthma was perceived in 60.3% of patients. The majority of patients (56.4%) reported not receiving education about asthma. Patients reflected misconceptions about the ED department, including the belief that more effective treatments are available (40.9%), or that the ED staff is better qualified (27.8%). About half of patients (48.2%) visited the ED because of the convenience of being open 24 hours, or because they are received immediately (38.4%). Uncontrolled asthma was associated with poor education about asthma and/or medication use. Patients educated about asthma, were less likely to stop corticosteroid therapy when their symptoms get better (OR:0.55; 95% CI:0.3-0.9; P = 0.04).
Conclusion:
This study reports that most patients had poor knowledge about asthma and were using medications improperly, thus suggesting inefficient application of management action plan. Unnecessary and frequent visits to the ED for asthma care was associated with poor education about asthma and medication use. Potential deficiencies of the health system at directing patients to the proper medical facility were uncovered and underline the necessity to improve education about the disease and medication compliance of patients and their parents/guardians.
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