Abstract
Asthma remains the second most common cause for admissions to a paediatric hospital bed. The aim of this study was to describe the characteristics of children admitted to hospital with an acute asthma attack and to identify factors that may prevent future hospital admissions. Parents of all children aged 3 to 15 years admitted to hospital for acute asthma were interviewed and the child's case record reviewed. Children were recruited consecutively in two groups: 141 summer/autumn and 125 winter/spring 1996. According to the pattern of symptoms in the previous 12 months, 61% of the children had infrequent episodic asthma, 26% had frequent episodic asthma, and 13% persistent asthma. Only 8% of children aged 8years or less had persistent asthma, in contrast to 22% of those aged > 8 years. There was evidence of both inadequate prescription of preventive treatment and poor compliance in the frequent episodic and persistent asthma groups. Of the whole group, 44% had previously been given an acute asthma management plan, but only 9% of them used it before the current hospital admission. There was a delay in seeking medical advice (> 24 hours after the onset of symptoms) in 27% of all admissions. This study has identified potential areas where intervention may reduce the number of future admissions.
Full Text
The Full Text of this article is available as a PDF (99.1 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Asthma: a follow up statement from an international paediatric asthma consensus group. Arch Dis Child. 1992 Feb;67(2):240–248. doi: 10.1136/adc.67.2.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Asthma: a follow up statement from an international paediatric asthma consensus group. Arch Dis Child. 1992 Feb;67(2):240–248. doi: 10.1136/adc.67.2.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bauman A., Mitchell C. A., Henry R. L., Robertson C. F., Abramson M. J., Comino E. J., Hensley M. J., Leeder S. R. Asthma morbidity in Australia: an epidemiological study. Med J Aust. 1992 Jun 15;156(12):827–831. doi: 10.5694/j.1326-5377.1992.tb136992.x. [DOI] [PubMed] [Google Scholar]
- Bishop J., Carlin J., Nolan T. Evaluation of the properties and reliability of a clinical severity scale for acute asthma in children. J Clin Epidemiol. 1992 Jan;45(1):71–76. doi: 10.1016/0895-4356(92)90190-x. [DOI] [PubMed] [Google Scholar]
- Dales R. E., Kerr P. E., Schweitzer I., Reesor K., Gougeon L., Dickinson G. Asthma management preceding an emergency department visit. Arch Intern Med. 1992 Oct;152(10):2041–2044. [PubMed] [Google Scholar]
- Dawson K. P., Jandera E., Penna A. C. The prehospital management of children with acute asthma. J Paediatr Child Health. 1992 Aug;28(4):321–322. doi: 10.1111/j.1440-1754.1992.tb02677.x. [DOI] [PubMed] [Google Scholar]
- Fireman P., Friday G. A., Gira C., Vierthaler W. A., Michaels L. Teaching self-management skills to asthmatic children and their parents in an ambulatory care setting. Pediatrics. 1981 Sep;68(3):341–348. [PubMed] [Google Scholar]
- Fitzclarence C. A., Henry R. L. Validation of an asthma knowledge questionnaire. J Paediatr Child Health. 1990 Aug;26(4):200–204. doi: 10.1111/j.1440-1754.1990.tb02429.x. [DOI] [PubMed] [Google Scholar]
- Garrett J., Kolbe J., Richards G., Whitlock T., Rea H. Major reduction in asthma morbidity and continued reduction in asthma mortality in New Zealand: what lessons have been learned? Thorax. 1995 Mar;50(3):303–311. doi: 10.1136/thx.50.3.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gibson P. G., Henry R. L., Vimpani G. V., Halliday J. Asthma knowledge, attitudes, and quality of life in adolescents. Arch Dis Child. 1995 Oct;73(4):321–326. doi: 10.1136/adc.73.4.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gillies J., Barry D., Crane J., Jones D., MacLennan L., Pearce N., Reid J., Toop L. A community trial of a written self management plan for children with asthma. Asthma Foundation of NZ Children's Action. N Z Med J. 1996 Feb 9;109(1015):30–33. [PubMed] [Google Scholar]
- Greenberger P. A. Preventing hospitalizations for asthma by improving ambulatory management. Am J Med. 1996 Apr;100(4):381–382. doi: 10.1016/S0002-9343(97)89511-3. [DOI] [PubMed] [Google Scholar]
- Griffiths C., Naish J., Sturdy P., Pereira F. Prescribing and hospital admissions for asthma in east London. BMJ. 1996 Feb 24;312(7029):481–482. doi: 10.1136/bmj.312.7029.481. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Martin A. J., Campbell D. A., Gluyas P. A., Coates J. R., Ruffin R. E., Roder D. M., Latimer K. M., Luke C. G., Frith P. A., Yellowlees P. M. Characteristics of near-fatal asthma in childhood. Pediatr Pulmonol. 1995 Jul;20(1):1–8. doi: 10.1002/ppul.1950200102. [DOI] [PubMed] [Google Scholar]
- Mitchell E. A., Bland J. M., Thompson J. M. Risk factors for readmission to hospital for asthma in childhood. Thorax. 1994 Jan;49(1):33–36. doi: 10.1136/thx.49.1.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitchell E. A., Burr D. Comparison of the characteristics of children with multiple admissions to hospital for asthma with those with a single admission. N Z Med J. 1987 Dec 9;100(837):736–738. [PubMed] [Google Scholar]
- Morisky D. E., Green L. W., Levine D. M. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986 Jan;24(1):67–74. doi: 10.1097/00005650-198601000-00007. [DOI] [PubMed] [Google Scholar]
- Newhouse M. T. Emergency department management of life-threatening asthma. Are nebulizers obsolete? Chest. 1993 Mar;103(3):661–663. doi: 10.1378/chest.103.3.661. [DOI] [PubMed] [Google Scholar]
- Palm C. R., Murcek M. A., Roberts T. R., Mansmann H. C., Jr, Fireman P. A review of asthma admissions and deaths at Children's Hospital of Pittsburgh from 1935 to 1968. J Allergy. 1970 Nov;46(5):257–269. doi: 10.1016/0021-8707(70)90067-5. [DOI] [PubMed] [Google Scholar]
- Peat J. K., van den Berg R. H., Green W. F., Mellis C. M., Leeder S. R., Woolcock A. J. Changing prevalence of asthma in Australian children. BMJ. 1994 Jun 18;308(6944):1591–1596. doi: 10.1136/bmj.308.6944.1591. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rachelefsky G. S. Review of asthma self-management programs. J Allergy Clin Immunol. 1987 Sep;80(3 Pt 2):506–511. doi: 10.1016/0091-6749(87)90087-x. [DOI] [PubMed] [Google Scholar]
- Rosier M. J., Bishop J., Nolan T., Robertson C. F., Carlin J. B., Phelan P. D. Measurement of functional severity of asthma in children. Am J Respir Crit Care Med. 1994 Jun;149(6):1434–1441. doi: 10.1164/ajrccm.149.6.8004295. [DOI] [PubMed] [Google Scholar]
- Sears M. R., Taylor D. R., Print C. G., Lake D. C., Herbison G. P., Flannery E. M. Increased inhaled bronchodilator vs increased inhaled corticosteroid in the control of moderate asthma. Chest. 1992 Dec;102(6):1709–1715. doi: 10.1378/chest.102.6.1709. [DOI] [PubMed] [Google Scholar]
- Toelle B. G., Peat J. K., Mellis C. M., Woolcock A. J. The cost of childhood asthma to Australian families. Pediatr Pulmonol. 1995 Jun;19(6):330–335. doi: 10.1002/ppul.1950190604. [DOI] [PubMed] [Google Scholar]
- Warner J. O., Götz M., Landau L. I., Levison H., Milner A. D., Pedersen S., Silverman M. Management of asthma: a consensus statement. Arch Dis Child. 1989 Jul;64(7):1065–1079. doi: 10.1136/adc.64.7.1065. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wennergren G., Kristjánsson S., Strannegård I. L. Decrease in hospitalization for treatment of childhood asthma with increased use of antiinflammatory treatment, despite an increase in prevalence of asthma. J Allergy Clin Immunol. 1996 Mar;97(3):742–748. doi: 10.1016/s0091-6749(96)80150-3. [DOI] [PubMed] [Google Scholar]
- Woolcock A., Rubinfeld A. R., Seale J. P., Landau L. L., Antic R., Mitchell C., Rea H. H., Zimmerman P. Thoracic society of Australia and New Zealand. Asthma management plan, 1989. Med J Aust. 1989 Dec 4;151(11-12):650–653. [PubMed] [Google Scholar]
- Yung M., South M., Byrt T. Evaluation of an asthma severity score. J Paediatr Child Health. 1996 Jun;32(3):261–264. doi: 10.1111/j.1440-1754.1996.tb01567.x. [DOI] [PubMed] [Google Scholar]