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Childhood Asthma - The Effect of Asthma Specialist Intervention on Asthma Control: A Retrospective Review
Yossi Rosman1,2, Linoy Gabay3, Tami Landau3
1Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel.
Insights
A single visit to a pediatric asthma specialist significantly improved asthma control in children. This intervention reduced emergency visits, hospitalizations, and reliance on corticosteroids, while increasing inhaled steroid use.
Area of Science:
- Pediatric Pulmonology
- Clinical Medicine
- Public Health
Background:
- Childhood asthma is a prevalent chronic condition in Western countries.
- Effective asthma control is a primary objective in pediatric healthcare management.
- Asthma affects millions of children, necessitating optimized management strategies.
Purpose of the Study:
- To assess the impact of a specialist consultation on pediatric asthma control.
- To evaluate the effectiveness of asthma specialist interventions in children.
- To determine if specialist visits improve asthma management outcomes.
Main Methods:
- Retrospective analysis of electronic health records from Maccabi Health Services (2000-2016).
- Included children aged 5-16 with an asthma diagnosis and at least one specialist visit.
- Compared asthma outcomes in the two years prior to and following the specialist consultation.
Main Results:
- A total of 13,533 children (36.5%) with asthma visited a specialist.
- Specialist visits correlated with decreased emergency department visits and hospitalizations (p<0.01).
- Prescriptions shifted from short-acting beta-agonists and corticosteroids to inhaled steroids post-consultation (p<0.01).
Conclusions:
- A single asthma specialist consultation yields significant positive outcomes for pediatric patients.
- Integrating specialist referrals into asthma management plans is recommended.
- Specialist care can optimize asthma control and reduce healthcare utilization in children.
Background:
Childhood asthma is the most common chronic disease throughout the western world. Improving asthma control is a leading health management goal.
Purpose:
To evaluate the effect of an intervention by a visit to an asthma specialist on asthma control in children.
Materials And Methods:
This retrospective study was conducted using the electronic database of Maccabi Health Services. All members ages 5-16 with an asthma diagnosis during 2000-2016, and at least one visit to a specialist were included. Asthma outcomes during the 2 years before and after the visit to the asthma specialist were compared.
Results:
A total of 37,066 children were diagnosed with asthma. Among them, 13,533 (36.5%) had at least one visit to an asthma specialist and were included. Children with asthma visited their primary care physician more often in the period before the specialist visit (4.4± 4.4 vs 3.16± 3.9 visits, respectively; p<0.01). After visiting a specialist, average number of visits to emergency departments (0.52± 1.3 vs 0.45±1), all cause hospitalizations (0.13±0.45 vs 0.08±0.4) and hospitalizations due to asthma exacerbations (0.08±0.345 vs 0.05±0.3) decreased (p<0.01 for all comparisons). Prescription of short-acting beta agonists decreased (2.85±3.6 vs 2.2 ±3.7, p<0.01) and inhaled steroid prescriptions increased (1.9±2.9 vs 2.7±3.7, p<0.01), respectively, after the intervention. A substantial reduction in the prescription of corticosteroids (0.81±1.9 vs 0.43±1.4, p<0.01) after specialist visit was also noted.
Conclusion:
We found significant positive outcomes after a single consultation with an asthma specialist. Referring pediatric asthma patients to an asthma specialist should be one of the goals of an asthma management plan.
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