Asthma affects 25 million Americans. It is the most common pediatric chronic disease, affecting 5.1 million children below the age of 18 years, or approximately 9% of all school-aged children. Asthma contributes to over 500,000 Emergency Department (ED) visits each year.  A new study led by UC San Francisco researchers found that follow-up care after an asthma-related visit to the ED may help prevent future ED visits for these children.

 “An urgent ED visit for asthma may suggest the child needs daily asthma medications to better control their asthma, or that they are having difficulty avoiding asthma triggers or recognizing symptoms,” said Naomi Bardach, MD, a UCSF pediatrics professor and lead author of the study. “Follow-up visits are an opportunity to educate the family and child on managing their asthma, prescribe new medications if needed, and ensure success in getting prescribed medications.”

 The study reviewed 90,267 ED visits by patients ages 3 to 21 years who received follow-up care within two weeks of an asthma-related ED visit. The data showed that only 23% of these patients received follow-up care, even though the current clinical practice guidelines recommend all patients be referred for follow-up within a month after an ED visit for asthma.  The patients in this study who did receive follow-up care within 2 weeks were 12% less likely to return to the ED for asthma within 60 days, and 13% less likely to revisit for asthma in the next year.  These patients were younger and more likely to have commercial insurance, complex chronic conditions, and evidence of prior asthma.

“Follow-up care is a team effort between ED clinicians, primary care clinicians, and families.  The protective effect of the follow-up visit at 14 days—even a year out—suggests that part of what is helpful is having an existing and trusting relationship with a clinician,” Bardach said. “Primary care and ED clinicians can support families by helping establish and maintain primary care connections.”

The paper was published online by Academic Pediatrics and funded by the Agency for Healthcare Research and Quality [U18HS025297 and U18HS020518].

The abstract can be found here


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