Skip to main content
NCBI home page
Journal of Accident & Emergency Medicine logoLink to Journal of Accident & Emergency Medicine
. 1997 Jan;14(1):16–20. doi: 10.1136/emj.14.1.16

A national census of those attending UK accident and emergency departments with asthma. The UK National Asthma Task Force.

M R Partridge 1, D Latouche 1, E Trako 1, J G Thurston 1
PMCID: PMC1342836  PMID: 9023616

Abstract

OBJECTIVE: To obtain a representative national picture of the type of people with asthma attending accident and emergency (A&E) departments in the UK, the reasons why they attend, and to determine the proportion admitted to hospital. DESIGN: A national census involving questionnaires. SETTING: 100 A&E departments throughout the UK. SUBJECTS: All those with asthma attending because of asthma during a one week period in September 1994. RESULTS: Details were obtained about 1292 attendances. About half of all attendances were by adults and half by children, and 87.8% were previously diagnosed asthmatics; 18.8% of adult attenders were unemployed. Perceived severity of asthma was the reason for attendance in 65.5%, but 11.5% reported non-availability, or perceived non-availability, of the general practitioner (GP) as the reason for attending. One fifth of adults had been kept awake by their asthma for over three nights before attendance. 425 of the 1292 attenders (32.9%) had been admitted to hospital in the previous 12 months and 316 (24.5%) had attended the A&E department in the previous three months. Only 24.6% of attenders had had contact with their general practitioner in the previous 24 h. 61.6% of under-5 attenders (n = 341) were admitted to hospital; the figures for those aged 5-15 and 15+ years and above were 265 (41.4%) and 665 (38.7%). CONCLUSIONS: Many people with asthma attend A&E departments without first having seen their GP. In many adult cases the asthma, while severe, is not acute, but a high proportion of both adults and children are admitted to hospital. Many of these attendances and admissions are repeat attendances. To enhance the quality of care provided to those with asthma may require easier access to primary care, enhanced patient education, or enhanced health professional education. Further study is needed of a variety of potential interventions.

Full text

PDF
16

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson H. R. Increase in hospital admissions for childhood asthma: trends in referral, severity, and readmissions from 1970 to 1985 in a health region of the United Kingdom. Thorax. 1989 Aug;44(8):614–619. doi: 10.1136/thx.44.8.614. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bailey W. C., Richards J. M., Jr, Brooks C. M., Soong S. J., Windsor R. A., Manzella B. A. A randomized trial to improve self-management practices of adults with asthma. Arch Intern Med. 1990 Aug;150(8):1664–1668. [PubMed] [Google Scholar]
  3. Blainey D., Lomas D., Beale A., Partridge M. The cost of acute asthma--how much is preventable? Health Trends. 1990;22(4):151–153. [PubMed] [Google Scholar]
  4. Chidley K. E., Wood-Baker R., Town G. I., Sleet R. A., Holgate S. T. Reassessment of asthma management in an accident and emergency department. Respir Med. 1991 Sep;85(5):373–377. doi: 10.1016/s0954-6111(06)80180-0. [DOI] [PubMed] [Google Scholar]
  5. Connett G. J., Warde C., Wooler E., Lenney W. Audit strategies to reduce hospital admissions for acute asthma. Arch Dis Child. 1993 Aug;69(2):202–205. doi: 10.1136/adc.69.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Coonar A. S., Nayeem N., Bonell C. P., Shires S. E. Adult asthma assessment in an accident & emergency department. J R Soc Med. 1994 Jun;87(6):330–330. doi: 10.1177/014107689408700610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. D'Souza W., Crane J., Burgess C., Te Karu H., Fox C., Harper M., Robson B., Howden-Chapman P., Crossland L., Woodman K. Community-based asthma care: trial of a "credit card" asthma self-management plan. Eur Respir J. 1994 Jul;7(7):1260–1265. doi: 10.1183/09031936.94.07071260. [DOI] [PubMed] [Google Scholar]
  8. Dale J., Green J., Reid F., Glucksman E., Higgs R. Primary care in the accident and emergency department: II. Comparison of general practitioners and hospital doctors. BMJ. 1995 Aug 12;311(7002):427–430. doi: 10.1136/bmj.311.7002.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Dales R. E., Schweitzer I., Kerr P., Gougeon L., Rivington R., Draper J. Risk factors for recurrent emergency department visits for asthma. Thorax. 1995 May;50(5):520–524. doi: 10.1136/thx.50.5.520. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Garrett J. E., Mulder J., Veale A. Trends in the use of an urban accident and emergency department by asthmatics. N Z Med J. 1988 May 25;101(846):253–255. [PubMed] [Google Scholar]
  11. Hadfield J. M., Yates D. W., Berry A. The emergency department and the community: a model for improved cooperation. J R Soc Med. 1994 Nov;87(11):663–665. [PMC free article] [PubMed] [Google Scholar]
  12. Hendricson W. D., Wood P. R., Hidalgo H. A., Kromer M. E., Parcel G. S., Ramirez A. G. Implementation of a physician education intervention. The Childhood Asthma Project. Arch Pediatr Adolesc Med. 1994 Jun;148(6):595–601. doi: 10.1001/archpedi.1994.02170060049008. [DOI] [PubMed] [Google Scholar]
  13. Ignacio-Garcia J. M., Gonzalez-Santos P. Asthma self-management education program by home monitoring of peak expiratory flow. Am J Respir Crit Care Med. 1995 Feb;151(2 Pt 1):353–359. doi: 10.1164/ajrccm.151.2.7842191. [DOI] [PubMed] [Google Scholar]
  14. Kun H. Y., Oates R. K., Mellis C. M. Hospital admissions and attendances for asthma--a true increase? Med J Aust. 1993 Sep 6;159(5):312–313. doi: 10.5694/j.1326-5377.1993.tb137867.x. [DOI] [PubMed] [Google Scholar]
  15. Kwong T., Town I., Holst P. E., Beasley R. A study of the management of asthma in a hospital emergency department. N Z Med J. 1989 Oct 25;102(878):547–549. [PubMed] [Google Scholar]
  16. Neville R. G., Clark R. C., Hoskins G., Smith B. National asthma attack audit 1991-2. General Practitioners in Asthma Group. BMJ. 1993 Feb 27;306(6877):559–562. doi: 10.1136/bmj.306.6877.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Newcomb R. W., Akhter J. Outcomes of emergency room visits for asthma. I. Patient determinants. J Allergy Clin Immunol. 1986 Feb;77(2):309–315. doi: 10.1016/s0091-6749(86)80109-9. [DOI] [PubMed] [Google Scholar]
  18. O'Halloran S. M., Heaf D. P. Accident and emergency department attendance by asthmatic children. Thorax. 1989 Sep;44(9):700–705. doi: 10.1136/thx.44.9.700. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Partridge M. R. Asthma education: more reading or more viewing? J R Soc Med. 1986 Jun;79(6):326–328. doi: 10.1177/014107688607900605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pedersen S. Ensuring compliance in children. Eur Respir J. 1992 Jan;5(1):143–145. [PubMed] [Google Scholar]
  21. Rao J. N. Follow up by telephone. BMJ. 1994 Dec 10;309(6968):1527–1528. doi: 10.1136/bmj.309.6968.1527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Raynor D. K., Booth T. G., Blenkinsopp A. Effects of computer generated reminder charts on patients' compliance with drug regimens. BMJ. 1993 May 1;306(6886):1158–1161. doi: 10.1136/bmj.306.6886.1158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rossi O. V., Kinnula V. L., Huhti E. Emergency room visits for acute attacks of asthma: characterization of patients and visits. Respiration. 1991;58(1):21–25. doi: 10.1159/000195890. [DOI] [PubMed] [Google Scholar]
  24. Taylor M. R. Asthma: audit of peak flow rate guidelines for admission and discharge. Arch Dis Child. 1994 May;70(5):432–434. doi: 10.1136/adc.70.5.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Town I., Kwong T., Holst P., Beasley R. Use of a management plan for treating asthma in an emergency department. Thorax. 1990 Sep;45(9):702–706. doi: 10.1136/thx.45.9.702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Wilson S. R., Scamagas P., German D. F., Hughes G. W., Lulla S., Coss S., Chardon L., Thomas R. G., Starr-Schneidkraut N., Stancavage F. B. A controlled trial of two forms of self-management education for adults with asthma. Am J Med. 1993 Jun;94(6):564–576. doi: 10.1016/0002-9343(93)90206-5. [DOI] [PubMed] [Google Scholar]
  27. Yoon R., McKenzie D. K., Bauman A., Miles D. A. Controlled trial evaluation of an asthma education programme for adults. Thorax. 1993 Nov;48(11):1110–1116. doi: 10.1136/thx.48.11.1110. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Accident & Emergency Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES