Comprehensive asthma care keeps kids out of the hospital, study suggests

Asthma is the leading cause of admissions at Children's Hospital Boston, particularly among minority patients from low socio-economic backgrounds. To improve asthma care in this high-risk group, researchers developed an "asthma medical home" within their primary care clinic. They identified 1,900 asthmatic patients and initiated education sessions that included a review of asthma basics, appropriate medication use, how to recognize and manage an asthma attack, and common environmental asthma triggers.

Families also received assistance obtaining medications; referrals to allergy and pulmonary specialists; and support in reducing environmental triggers, which included access to dust mite covers and home visits for assessments and remediation of identified triggers (e.g., pests, mold).

Emergency department (ED) visits and inpatient hospitalization rates in the year before the program was in place were compared with those two years after program initiation.

Results showed that ED visits for asthma-related reasons decreased 63 percent (from 26 percent in 2006 to 9.9 percent in 2009), while inpatient hospitalization rates decreased 62 percent (from 10.5 to 4 percent).

"With increased access to their primary care providers, increased knowledge about their child's disease process and greater control over environmental triggers, families are better empowered to manage their children's asthma symptoms," said Faye F. Holder-Niles, MD, MPH, lead author of the study. "This comprehensive approach to asthma can have tremendous impact on the lives of asthmatic patients."