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Abstract
BACKGROUND: Asthma is the most common chronic disease leading to hospital admissions and readmissions in childhood. Bedside nurses and respiratory therapists are the primary asthma educators, but they may lack time or knowledge to provide comprehensive asthma education and identify barriers to care. Patients and their parent(s) may benefit from comprehensive education and assessment of barriers from a certified asthma educator.
METHODS: A team of certified asthma educators used a quality improvement method to create an in-patient asthma education consulting service. The in-patient pulmonary consult and medical teams referred subjects ≥ 1 y in age with a new or existing diagnosis of asthma who had been admitted to the ICU or identified as having concerns for poor medication adherence to the asthma consult. The asthma consult provided face-to-face education with the subject and parent(s), addressed barriers to the plan of care, and helped facilitate appointments to an asthma specialist after discharge.
RESULTS: There were 126 subjects eligible for the asthma consult pilot implemented October 1, 2018–April 30, 2020. The asthma consult saw 52 subjects. Subjects who received consults had a higher rate of previous health care utilization and existing specialist for asthma. After the in-patient stay, the odds of returning to the emergency department/urgent care (UC) or hospital within the following 12 months did not differ between asthma consult and control group. However, after adjusting for covariates of age, race, ethnicity, previous health care utilization, and existing specialist, there was a significant difference in the odds of readmission and revisits (adjusted odds ratio 0.39 [95% CI 0.16–0.98], P = .04) for the asthma consult group compared to the control group.
CONCLUSIONS: Providing comprehensive, face-to-face asthma education and working with subjects and their parent(s) to address barriers to medication adherence and facilitate specialty follow-up post discharge decreased health care utilization.
- asthma/prevention and control
- patient education
- patient care planning
- patient readmissions
- discharge planning
- hospitalized subjects
- asthma education
- medication adherence
- children’s health
Footnotes
- Correspondence: Joyce A Baker MBA RRT RRT-NPS AE-C FAARC, Breathing Institute, Children’s Hospital Colorado, 13123 E 16th Ave, Aurora, Colorado 80045. E-mail: joyce.baker{at}childrenscolorado.org
Supplementary material related to this paper is available at http://rc.rcjournal.com.
The authors have disclosed no conflicts of interest.
A version of this paper was presented by Ms Baker at the University of Colorado Denver, Department of Pediatrics Fellowship Research Education and Support: 2020 Virtual Pediatric Spring Poster Session held May 29, 2020; and as an Editors’ Choice abstract at AARC Congress 2020 LIVE!, held virtually on November 18, 2020.
The study was performed at Children’s Hospital Colorado, Aurora, Colorado.
- Copyright © 2022 by Daedalus Enterprises
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