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Home supply of emergency oral steroids and reduction in asthma healthcare utilization
Author(s) -
Sarzynski Lisa M.,
Turner Tiffany,
Stukus David R.,
Allen Elizabeth
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23892
Subject(s) - medicine , asthma , emergency department , medical prescription , poisson regression , emergency medicine , asthma exacerbations , pediatrics , intensive care unit , population , environmental health , psychiatry , pharmacology
Objective To determine if children with moderate‐to‐severe persistent asthma have decreased healthcare utilization after receiving a prescription and instructions to use an at home emergency supply of oral steroids during asthma exacerbations. Methods A quasi‐experimental design study with a historical control from retrospective chart review was performed for patients aged 2‐18 years seen in a tertiary care pediatric pulmonary clinic for moderate to severe persistent asthma. Baseline utilization of the emergency department, inpatient hospital, and pediatric intensive care unit for asthma exacerbations was collected from 24 months prior to initial prescription for at home steroids and compared with 12 months post‐intervention using Poisson Regression. A subgroup analysis was performed for ages 6‐18 evaluating school age children alone. Results Patients ( N = 132) were averaged 10 years ± 3.9 years of age and 57% of patients were male. Emergency Department visit rates significantly declined in the 12 months after receiving a prescription and instructions for home emergency steroid supply compared with the 12 months prior to this intervention (0.39 visits/patient/year vs 0.67, P < 0.01). There was a trend for a decline in inpatient (0.27 visits/patient/year vs 0.11, P = 0.09) and pediatric intensive care unit stay rates (0.11 visits/patient/year vs 0.05, P = 0.06). A subgroup analysis of ages 6‐18 found similar results. Conclusions Incorporation of home emergency oral steroids into the home management plan of children with moderate‐to‐severe asthma can reduce asthma related Emergency Department visits.