Effectiveness of acute asthma care among inner-city adults

Yvonne Marie Coyle, Corinne Chie Aragaki, Linda Susan Hynan, Rebecca Sue Gruchalla, David Ali Khan

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Acute asthma often requires expensive emergency department visits and hospitalizations, especially among economically disadvantaged inner-city adults. However, few studies have examined approaches for improving acute asthma care in this population. Methods: We conducted a cohort study involving patients who were discharged from a public hospital emergency department following acute asthma care between March 31, 1997, and August 5, 1999, to identify processes of care effective for improving peak expiratory flow rate at a 2- to 3-week follow-up. Adult patients who met the predetermined criteria for asthma, who underwent a baseline peak expiratory flow rate reading, and who did not have concurrent acute sinusitis or pneumonia were eligible (N = 448). Of the 365 patients enrolled in the study, 309 (84.7%) completed it. We used a multiple linear regression analysis adjusted for patient risk to assess the association between acute asthma care processes derived from the National Asthma Education Prevention Program guidelines (inhaled β2-agonists, inhaled corticosteroids, systemic corticosteroids, asthma care follow-up, and patient asthma education) and percentage peak expiratory flow rate change at follow-up. Results: Systemic corticosteroids had a significant effect for increasing percentage peak expiratory flow rate change at the 2- to 3-week follow-up for all asthma exacerbation severity levels (β = 26.1; 95% confidence interval, 1.8-50.5; P=.04) and severity levels specified by the National Asthma Education Prevention Program guidelines (β = 31.6; 95% confidence interval, 8.1-55.1; P=.01). Conclusion: Outpatient systemic corticosteroids were effective for improving lung function 2 to 3 weeks after acute asthma care, and their use should reduce asthma-related morbidity, especially among economically disadvantaged inner-city adults.

Original languageEnglish (US)
Pages (from-to)1591-1596
Number of pages6
JournalArchives of Internal Medicine
Volume163
Issue number13
DOIs
StatePublished - Jul 14 2003

ASJC Scopus subject areas

  • Internal Medicine

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