Poor asthma education and medication compliance are associated with increased emergency department visits by asthmatic children

Abstract

BACKGROUND:Acute exacerbations of bronchial asthma remain a major cause of frequent Emergency Department (ED) visits by pediatric patients. However, other factors including psychosocial, behavioural and educational, are also reportedly associated with repetitive ED visits. Therefore, it is necessary to determine whether such visits are justifiable.OBJECTIVE:The objective of this cross-sectional study was to identify risk factors associated with visits to ED by asthmatic children.METHODS:Asthmatic children (n = 297) between 1-17 years old were recruited and information collected at the time of visiting an ED facility at two major hospitals.RESULTS:Asthmatic patients visited the ED 3.9 ΁ 3.2 times-per-year, on average. Inadequately controlled asthma was perceived in 60.3% of patients. The majority of patients (56.4%) reported not receiving education about asthma. Patients reflected misconceptions about the ED department, including the belief that more effective treatments are available (40.9%), or that the ED staff is better qualified (27.8%). About half of patients (48.2%) visited the ED because of the convenience of being open 24 hours, or because they are received immediately (38.4%). Uncontrolled asthma was associated with poor education about asthma and/or medication use. Patients educated about asthma, were less likely to stop corticosteroid therapy when their symptoms get better (OR:0.55; 95% CI:0.3-0.9; P = 0.04).CONCLUSION:This study reports that most patients had poor knowledge about asthma and were using medications improperly, thus suggesting inefficient application of management action plan. Unnecessary and frequent visits to the ED for asthma care was associated with poor education about asthma and medication use. Potential deficiencies of the health system at directing patients to the proper medical facility were uncovered and underline the necessity to improve education about the disease and medication compliance of patients and their parents/guardians.

Factors leading to refractory asthma in patients from Saudi Arabia

“…[519] Most of the data related to asthma control in asthma from Saudi Arabia are mostly conducted in children with variable prevalence. [2223] However, an asthma control survey was conducted in Riyadh that showed 95% were either partially controlled or uncontrolled. [24] Another recent cross-sectional study from a University hospital in Jeddah revealed that 88% were uncontrolled.…”

Efficacy of an Asthma Self-management Education Intervention for Children (9-13 Years) with Asthma and Their Caregiver in Wuhan, China

“…Lacking knowledge and misunderstanding of the required therapies are the main reasons for substandard asthma treatment [8,29,30]. Therefore, it is important to educate nurses in China about proper asthma management for children.…”

Development and Implementation of an Evidence-based Self-regulation Intervention: Effect on Knowledge and Perceived Control Among Adult Patients with Asthma

“…Many observations have shown that the effects will not improve unless patient education and cooperation become the element of the treatment process [12]. Al-Muhsen et al [19] reported that most patients had poor knowledge about asthma and were using medications improperly, suggesting inefficient application of management plan. Yun and Cho [20] added that factors hampering patients' efforts to reduce the burden of asthma include lack of information, under-use of self-management, over-reliance on acute care and use of alternative unproven therapies.…”