2001 OPEN FORUM Abstracts
ISSUES RELATED TO WHY FAMILIES USETHE EMERGENCY DEPARTMENT FOR ASTHMA TREATMENT
Teresa M. Iatridis, MS, RRT, MichelleWoods, American Lung Association of Georgia, Atlanta, GA, W. Michele White,Pharm.D., Michele Mindlin, M.U.P., Gloria Chen, RN, MBA, Georgia Departmentof Human Resources-Public Health Branch, James Bason, Ph.D., University of Georgia,Athens, GA, Lynda Thomas Goodfellow, Ed.D., RRT, Georgia State University, Atlanta,GA.
Asthma is one of the most commonchronic illnesses among children. It has been estimated that the treatment ofasthma costs $6.2 billion per year in direct and indirect expenditures. Approximately43% of this amount can be directly associated with emergency department (ED)visits, hospitalizations, and death. The purpose of this study was to beginto understand the many circumstances leading to the usage of the ED for treatmentof asthma. The research question guiding the researchers was: What are the specificreasons why families use the ED for asthma treatment? A convenience sample (n=36)was obtained from participants using the ED at 5 participating hospitals. Participantswere the parent/guardian of children with asthma, ages 0-17. After signed consentwas obtained, participants were contacted 1-2 weeks after the ED visit for aphone interview regarding using the ED to treat their childÕs recent asthmaepisode. The findings can be classified into two categories. The first was IssuesRelated to the Health Care Delivery System. Sixty-seven percent reported thatthey were covered by a third party insurance provider and have their own regularphysician. A majority of the participants (61%) utilized the ED for treatmentof their childÕs asthma during non-business hours. The majority reported medicationuse, but only 3% reported using the recommended combination therapy of longand short acting beta agonists, inhaled corticosteriod, and stabilizer medication.Approximately 25% of the participants expressed concerns relating to medicationcosts when asked about their Òbiggest challengesÓ in daily asthma management.The second category found was Issues Related to the FamilyÕs Ability to ManageAsthma Episodes. Thirty-six percent reported doing nothing prior to bringingtheir child to the ED. Most respondents (72%) reported that the decision tobring their child to the ED for treatment was made by an adult living in thehouse. Less than half (47%) reported having a written asthma action plan fordaily management of their childÕs asthma. Of those that did, only 14% describeda plan that seemed appropriate, based on NIH asthma care guidelines. Finally,58% reported that asthma often interferes with normal daily activities, yetwhen asked if they believe that the current treatment was working, 82% repliedÒyesÓ. From the information obtained, it appears that asthma-related ED visitscould possibly be reduced through further education and intervention planning.The proper education regarding disease management, recognition of signs andsymptoms, medication administration, and expected outcomes would be beneficialto the patient, their families, and their health care providers. This studywas supported by the Georgia Department of Human Resources, the American LungAssociation of Georgia, and the WG Raoul Foundation.