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Documentation of asthma control and severity in pediatrics: analysis of national office-based visits
Sanika Rege1, Abhishek Kavati2, Benjamin Ortiz3
1Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, TX, USA.
Insights
Documentation of pediatric asthma control and severity is critically low, affecting care quality. Improving these records is essential for better asthma management in children.
Area of Science:
- Pediatric Pulmonology
- Health Services Research
- Clinical Informatics
Background:
- Asthma is a prevalent chronic respiratory condition in children, requiring consistent management.
- Effective asthma care relies on accurate documentation of disease control and severity.
- Current documentation practices in pediatric asthma care are not well understood.
Purpose of the Study:
- To assess the extent of asthma control and severity documentation in pediatric patients.
- To identify characteristics associated with documented asthma control and severity.
- To evaluate factors influencing uncontrolled asthma in children.
Main Methods:
- Cross-sectional study using 2012-2015 National Ambulatory Medical Care Survey (NAMCS) data.
- Included pediatric patients (6-17 years) with an asthma diagnosis.
- Weighted descriptive analysis and logistic regression to identify associated characteristics.
Main Results:
- An average of 2.47 million annual pediatric asthma visits were identified.
- Asthma control and severity were documented in only 36.1% and 33.8% of visits, respectively.
- Established patients, Hispanic ethnicity, and certain geographic regions showed higher odds of documented asthma control.
Conclusions:
- There is a significant gap in documenting asthma control and severity for pediatric patients.
- Improving documentation is crucial for enhancing the quality of asthma care.
- Further research and interventions are needed to address documentation deficits.
Abstract:
Objective: To evaluate the extent of documentation of asthma control and severity and associated characteristics among pediatric asthma patients in office-based settings. Methods: This cross-sectional study utilized data from the 2012-2015 National Ambulatory Medical Care Survey (NAMCS). Patients aged 6-17 years with a diagnosis of asthma were included. Weighted descriptive analysis examined the extent of documentation and uncontrolled asthma; while logistic regression evaluated associated characteristics. Results: Overall, there were 2.47 million (95% confidence interval, 95% CI: 2.04-2.90) average annual visits with asthma as a primary diagnosis. Asthma control and severity was documented in only 36.1% and 33.8% of the visits, respectively. An established patient (odds ratio, OR = 3.81), Hispanic ethnicity (OR = 2.10), chronic sinusitis (OR = 5.59), and visits in the Northeast (OR = 2.12) and Midwest (OR = 2.25) regions had higher odds of documented asthma control status, whereas undocumented asthma severity (OR = 0.02), and visits in spring (OR = 0.34), had lower odds. Osteopathic doctors (OR = 0.18), visits in the Northeast region (OR = 0.23), chronic sinusitis (OR = 0.08), and undocumented asthma control status (OR = 0.03) had lower odds of documented asthma severity, whereas visits in spring (OR = 3.88) and autumn (OR = 3.32) had higher odds. Moderate/severe persistent asthma (OR = 15.35) had higher odds of uncontrolled asthma (as compared to intermittent asthma), while visits in the summer (OR = 0.14) had lower odds. Conclusion: The findings of this study suggest a critical need to increase the documentation of asthma severity and control to improve quality of asthma care in children.
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