Asthma Hospitalizations in Kids Often Preventable

NEW YORK (Reuters Health) - In many cases, the need to hospitalize children with asthma could be averted by better communication with the physician and better medication adherence, according to a report in the medical journal Pediatrics.

"The most important step primary care providers can take to prevent pediatric asthma hospitalizations is to ensure that parents and children are well educated about the child's condition, medications, the need for follow-up care, and the importance of avoiding known disease triggers," Dr. Glenn Flores from the Medical College of Wisconsin, Milwaukee, told Reuters Health.

Flores and colleagues examined 230 asthma hospitalizations to determine the proportion of hospitalizations that were preventable and how they might have been prevented.

On a case-by-case basis, 26 percent of parents, 38 percent of the primary care providers, and 43 percent of the hospital physicians deemed the hospitalization preventable, the authors report.

Most reasons for preventability were parent- and patient-related, the report indicates -- most commonly medication issues and delays or failures in obtaining needed follow-up medical care.

Physician-related reasons included insufficiently aggressive treatment and inadequate prescription of inhaled steroids.

More hospitalizations were preventable for adolescent patients than for the youngest children, the researchers note, and uninsured children were much more likely than insured children to have preventable hospitalizations.

Having made no telephone call or office visit to the physician before the hospitalization and an age of 11 years or older were associated with preventable asthma hospitalizations.

"We are currently conducting a study to determine whether Parent Mentors are more effective than traditional asthma care in reducing childhood asthma morbidity, costs, and use of services while increasing families' quality of life, satisfaction, and self-efficacy," Flores said.

"Targeting adolescents for additional education, particularly regarding asthma self-management skills, may prove useful in reducing preventable asthma hospitalizations," he added.

SOURCE: Pediatrics, October 2005.