Pediatric asthma hospitalizations alert to poor disease management
medwireNews: Researchers from Italy say that the majority of hospitalizations for pediatric asthma reflect inadequate disease management rather than disease severity.
Their 3-year study of 6–17-year olds found that nearly half (45%) of 183 children hospitalized had not received any therapy in the 12 months prior. And, 22% of these patients still did not receive any therapy, even after hospitalization.
Reporting in PloS One, authors Marina Bianchi and colleagues, from the Instituto di Ricerche Farmacologiche Mario Negris in Milan, found that overall adherence to the Global Initiative for Asthma (GINA) guidelines was poor.
Less than a quarter of children were treated in accordance with the guidelines before and after their hospitalization. These patients received drug therapy both before and after their hospitalization, and underwent spirometry or were seen by a specialist in the 12 months following hospitalization.
But 41% of patients did not undergo any spirometry or receive a visit from a specialist either before or after their hospitalization.
Consequently, the authors categorized 44% of hospitalized patients as potentially non-adherent and 31% as potentially adherent.
“[W]hen asthma requires hospitalization it should be necessary to distinguish between lack of disease control due to severe/difficult-to-treat cases and non adequately treated/managed cases,” comment Bianchi and colleagues.
They say their results suggest that around half of their hospitalized patients had either an inaccurate diagnosis, were undertreated by their physician, or were not compliant with their therapy.
“In all these cases, hospitalization would be a proxy indicator of preventable poor control of disease, rather than a proxy indicator of severity,” the authors comment.
They conclude that their findings add to previous evidence of low guideline compliance in pediatric asthma, highlighting inadequate use both of therapy and monitoring, and the need for enhanced outpatient care.
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By Kirsty Oswald, medwireNews Writer