Majority of Patients With Asthma Do Not Receive Guideline-Directed Therapy in the Emergency Department

November 20, 2020

By Ed Susman

WEST PALM BEACH, Fla -- November 19, 2020 -- When patients who are experiencing asthma exacerbation present at the emergency department, they frequently do not receive guideline-directed treatment, education, or medication, according to a study presented at the Virtual 2020 Annual Meeting of the American College of Allergy, Asthma and Immunology (ACAAI).

“This study demonstrates that the vast majority of patients admitted to the emergency department for asthma exacerbation did not receive guideline-directed medical therapy,” said Rose Monahan, MD, University of South California University Medical Center, Los Angeles, California. “The two greatest areas of discrepancy between the guidelines and actual practice were prescribing appropriate medical therapy and providing inhaler technique education at discharge.”

The researchers analysed data from patients with asthma aged 22 to 75 years admitted to the emergency department of an urban tertiary cancer center between May 1, 2013, and May 1, 2015 for an asthma exacerbation. The researchers used the 2007 National Heart Lung Blood Institute Expert Panel Review 3 guidelines to determine if patients received appropriate medical care including both step of therapy at discharge and patient education as markers of appropriate therapy.

Of 70 patient visits examined, only 5.71% of patients received guideline-directed medical therapy. In addition, about 93% of patients in the study were not given inhaler/medication education.

“Given the results, we hope to implement changes to our discharge education for patients with asthma with inhaler teaching and further education on medications and adherence,” said Dr. Monahan. “We also hope to implement an easy dot-phrase that medical personnel can use to better determine the appropriate steps of therapy at discharge.”

[Presentation title: Retrospective Evaluation of Adherence to Asthma Guidelines Among Adult Patients After Emergency Department Visit or Hospital Admission. Poster P200]