Article Text

  1. K. M. Maples,
  2. I. Chen
  1. Eastern Virginia Medical School, Norfolk


Introduction Asthma is a prevalent, chronic inflammatory disease. It is estimated that the annual cost of asthma related illness in the United States is 11.3 billion dollars. Focus on the prevention of exacerbations and sound patient education is paramount. Previous work has shown that patients seen in an emergency department for asthma-related symptoms have poor knowledge about basic asthma pathophysiology, but did not compare these patients to nonemergency department users or address knowledge of how asthma medications should be used (Meyer et al, 2001).

Methods We surveyed adult patients with a diagnosis of asthma from 7 different outpatient sites. The questionnaire consisted of 21 questions on demographics, current asthma medication usage, understanding of asthma medications, frequency of symptoms, missed school and work, emergency department visits, hospitalizations, oral steroid usage, and type of treating physician.

Results We present preliminary data on the first 89 patients surveyed. Of these patients, 65 were on inhaled preventative therapy. Interestingly, only 26 (40%) of these patients reported taking their preventative therapy correctly. We analyzed patients according to those correctly versus incorrectly taking inhaled preventative therapy. Patients in both groups felt that their doctors had spent enough time talking with them regarding their asthma therapy. Of the 65 patients, 5 had been admitted to the hospital over the last year. All of these patients were in the group taking inhaled preventative therapy incorrectly, p = .05. When looking at ER visits for patients in the two groups, 51% of patients in the incorrect group had used the ER in the last year, while only 15% of patients in the correct group had used the ER in the last year (OR = 5.81, p = .003).

Conclusions In this small study it is clear that patients who report that they understand how to take their preventative therapy visit the ER significantly less frequently. These data suggest that time spent assuring that asthma patients understand their medication may lead to less downstream resource utilization. Further studies to investigate the direct correlation of office time dedicated to improving asthma knowledge and disease outcome are needed.

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