Children and Adults With Frequent Hospitalizations for Asthma Exacerbation, 2012-2013

A Multicenter Observational Study

Multicenter Airway Research Collaboration-37 Investigators

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Earlier studies reported that many patients were frequently hospitalized for asthma exacerbation. However, there have been no recent multicenter studies to characterize this patient population with high morbidity and health care utilization. Objective: To examine the proportion and characteristics of children and adults with frequent hospitalizations for asthma exacerbation. Methods: A multicenter chart review study of patients aged 2 to 54 years who were hospitalized for asthma exacerbation at 1 of 25 hospitals across 18 US states during the period 2012 to 2013 was carried out. The primary outcome was frequency of hospitalizations for asthma exacerbation in the past year (including the index hospitalization). Results: The cohort included 369 children (aged 2-17 years) and 555 adults (aged 18-54 years) hospitalized for asthma exacerbation. Over the 12-month period, 36% of the children and 42% of the adults had 2 or more (frequent) hospitalizations for asthma exacerbation. Among patients with frequent hospitalizations, guideline-recommended outpatient management was suboptimal. For example, among adults, 32% were not on inhaled corticosteroids at the time of index hospitalization and 75% had no evidence of a previous evaluation by an asthma specialist. At hospital discharge, among adults with frequent hospitalizations who had used no controller medications previously, 37% were not prescribed inhaled corticosteroids. Likewise, during a 3-month postdischarge period, 64% of the adults with frequent hospitalizations were not referred to an asthma specialist. Although the proportion of patients who did not receive these guideline-recommended outpatient care appeared higher in adults, these preventive measures were still underutilized in children; for example, 38% of the children with frequent hospitalizations were not referred to asthma specialist after the index hospitalization. Conclusions: This multicenter study of US patients hospitalized with asthma exacerbation demonstrated a disturbingly high proportion of patients with frequent hospitalizations and ongoing evidence of suboptimal longitudinal asthma care.

Original languageEnglish (US)
Pages (from-to)751-758.e1
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume3
Issue number5
DOIs
StatePublished - Sep 1 2015

Fingerprint

Multicenter Studies
Observational Studies
Hospitalization
Asthma
Adrenal Cortex Hormones
Patient Acceptance of Health Care
Guidelines
Ambulatory Care
Outpatients
Morbidity

Keywords

  • Asthma
  • Asthma specialist
  • Hospitalization
  • Inhaled corticosteroids
  • Multicenter study

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Children and Adults With Frequent Hospitalizations for Asthma Exacerbation, 2012-2013 : A Multicenter Observational Study. / Multicenter Airway Research Collaboration-37 Investigators.

In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 3, No. 5, 01.09.2015, p. 751-758.e1.

Research output: Contribution to journalArticle

@article{82e9c69a2c63438a9ccda1cb714d434f,
title = "Children and Adults With Frequent Hospitalizations for Asthma Exacerbation, 2012-2013: A Multicenter Observational Study",
abstract = "Background: Earlier studies reported that many patients were frequently hospitalized for asthma exacerbation. However, there have been no recent multicenter studies to characterize this patient population with high morbidity and health care utilization. Objective: To examine the proportion and characteristics of children and adults with frequent hospitalizations for asthma exacerbation. Methods: A multicenter chart review study of patients aged 2 to 54 years who were hospitalized for asthma exacerbation at 1 of 25 hospitals across 18 US states during the period 2012 to 2013 was carried out. The primary outcome was frequency of hospitalizations for asthma exacerbation in the past year (including the index hospitalization). Results: The cohort included 369 children (aged 2-17 years) and 555 adults (aged 18-54 years) hospitalized for asthma exacerbation. Over the 12-month period, 36{\%} of the children and 42{\%} of the adults had 2 or more (frequent) hospitalizations for asthma exacerbation. Among patients with frequent hospitalizations, guideline-recommended outpatient management was suboptimal. For example, among adults, 32{\%} were not on inhaled corticosteroids at the time of index hospitalization and 75{\%} had no evidence of a previous evaluation by an asthma specialist. At hospital discharge, among adults with frequent hospitalizations who had used no controller medications previously, 37{\%} were not prescribed inhaled corticosteroids. Likewise, during a 3-month postdischarge period, 64{\%} of the adults with frequent hospitalizations were not referred to an asthma specialist. Although the proportion of patients who did not receive these guideline-recommended outpatient care appeared higher in adults, these preventive measures were still underutilized in children; for example, 38{\%} of the children with frequent hospitalizations were not referred to asthma specialist after the index hospitalization. Conclusions: This multicenter study of US patients hospitalized with asthma exacerbation demonstrated a disturbingly high proportion of patients with frequent hospitalizations and ongoing evidence of suboptimal longitudinal asthma care.",
keywords = "Asthma, Asthma specialist, Hospitalization, Inhaled corticosteroids, Multicenter study",
author = "{Multicenter Airway Research Collaboration-37 Investigators} and Kohei Hasegawa and Bittner, {Jane C.} and Stephanie Nonas and Stoll, {Samantha J.} and Taketo Watase and Susan Gabriel and Vivian Herrera and Camargo, {Carlos A.} and Taruna Aurora and Barry Brenner and Brown, {Mark A.} and William Calhoun and Gough, {John E.} and Gutta, {Ravi C.} and Jonathan Heidt and Mehdi Khosravi and Moore, {Wendy C.} and Mould-Millman, {Nee Kofi} and Richard Nowak and Jason Ahn and Veronica Pei and Press, {Valerie G.} and Probst, {Beatrice D.} and Ramratnam, {Sima K.} and Heather Hartman and Carly Snipes and Teuber, {Suzanne S.} and Trent, {Stacy A.} and Roberto Villarreal and Scott Youngquist",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.jaip.2015.05.003",
language = "English (US)",
volume = "3",
pages = "751--758.e1",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Children and Adults With Frequent Hospitalizations for Asthma Exacerbation, 2012-2013

T2 - A Multicenter Observational Study

AU - Multicenter Airway Research Collaboration-37 Investigators

AU - Hasegawa, Kohei

AU - Bittner, Jane C.

AU - Nonas, Stephanie

AU - Stoll, Samantha J.

AU - Watase, Taketo

AU - Gabriel, Susan

AU - Herrera, Vivian

AU - Camargo, Carlos A.

AU - Aurora, Taruna

AU - Brenner, Barry

AU - Brown, Mark A.

AU - Calhoun, William

AU - Gough, John E.

AU - Gutta, Ravi C.

AU - Heidt, Jonathan

AU - Khosravi, Mehdi

AU - Moore, Wendy C.

AU - Mould-Millman, Nee Kofi

AU - Nowak, Richard

AU - Ahn, Jason

AU - Pei, Veronica

AU - Press, Valerie G.

AU - Probst, Beatrice D.

AU - Ramratnam, Sima K.

AU - Hartman, Heather

AU - Snipes, Carly

AU - Teuber, Suzanne S.

AU - Trent, Stacy A.

AU - Villarreal, Roberto

AU - Youngquist, Scott

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background: Earlier studies reported that many patients were frequently hospitalized for asthma exacerbation. However, there have been no recent multicenter studies to characterize this patient population with high morbidity and health care utilization. Objective: To examine the proportion and characteristics of children and adults with frequent hospitalizations for asthma exacerbation. Methods: A multicenter chart review study of patients aged 2 to 54 years who were hospitalized for asthma exacerbation at 1 of 25 hospitals across 18 US states during the period 2012 to 2013 was carried out. The primary outcome was frequency of hospitalizations for asthma exacerbation in the past year (including the index hospitalization). Results: The cohort included 369 children (aged 2-17 years) and 555 adults (aged 18-54 years) hospitalized for asthma exacerbation. Over the 12-month period, 36% of the children and 42% of the adults had 2 or more (frequent) hospitalizations for asthma exacerbation. Among patients with frequent hospitalizations, guideline-recommended outpatient management was suboptimal. For example, among adults, 32% were not on inhaled corticosteroids at the time of index hospitalization and 75% had no evidence of a previous evaluation by an asthma specialist. At hospital discharge, among adults with frequent hospitalizations who had used no controller medications previously, 37% were not prescribed inhaled corticosteroids. Likewise, during a 3-month postdischarge period, 64% of the adults with frequent hospitalizations were not referred to an asthma specialist. Although the proportion of patients who did not receive these guideline-recommended outpatient care appeared higher in adults, these preventive measures were still underutilized in children; for example, 38% of the children with frequent hospitalizations were not referred to asthma specialist after the index hospitalization. Conclusions: This multicenter study of US patients hospitalized with asthma exacerbation demonstrated a disturbingly high proportion of patients with frequent hospitalizations and ongoing evidence of suboptimal longitudinal asthma care.

AB - Background: Earlier studies reported that many patients were frequently hospitalized for asthma exacerbation. However, there have been no recent multicenter studies to characterize this patient population with high morbidity and health care utilization. Objective: To examine the proportion and characteristics of children and adults with frequent hospitalizations for asthma exacerbation. Methods: A multicenter chart review study of patients aged 2 to 54 years who were hospitalized for asthma exacerbation at 1 of 25 hospitals across 18 US states during the period 2012 to 2013 was carried out. The primary outcome was frequency of hospitalizations for asthma exacerbation in the past year (including the index hospitalization). Results: The cohort included 369 children (aged 2-17 years) and 555 adults (aged 18-54 years) hospitalized for asthma exacerbation. Over the 12-month period, 36% of the children and 42% of the adults had 2 or more (frequent) hospitalizations for asthma exacerbation. Among patients with frequent hospitalizations, guideline-recommended outpatient management was suboptimal. For example, among adults, 32% were not on inhaled corticosteroids at the time of index hospitalization and 75% had no evidence of a previous evaluation by an asthma specialist. At hospital discharge, among adults with frequent hospitalizations who had used no controller medications previously, 37% were not prescribed inhaled corticosteroids. Likewise, during a 3-month postdischarge period, 64% of the adults with frequent hospitalizations were not referred to an asthma specialist. Although the proportion of patients who did not receive these guideline-recommended outpatient care appeared higher in adults, these preventive measures were still underutilized in children; for example, 38% of the children with frequent hospitalizations were not referred to asthma specialist after the index hospitalization. Conclusions: This multicenter study of US patients hospitalized with asthma exacerbation demonstrated a disturbingly high proportion of patients with frequent hospitalizations and ongoing evidence of suboptimal longitudinal asthma care.

KW - Asthma

KW - Asthma specialist

KW - Hospitalization

KW - Inhaled corticosteroids

KW - Multicenter study

UR - http://www.scopus.com/inward/record.url?scp=84941259735&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941259735&partnerID=8YFLogxK

U2 - 10.1016/j.jaip.2015.05.003

DO - 10.1016/j.jaip.2015.05.003

M3 - Article

VL - 3

SP - 751-758.e1

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

IS - 5

ER -