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Pediatric Academic Societies Annual Meeting
May 06, 2016
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Written asthma action plans reduce short-term exacerbation incidence

BALTIMORE — Patients with written asthma action plans had a decreased risk for recurring exacerbations within 1 year of plan distribution, according to study findings presented at the Pediatric Academic Societies Meeting.

“A retrospective chart review was performed to assess the impact of having an active written asthma action plan [WAAP] on asthma exacerbation frequency in an underserved, inner-city, outpatient pediatric clinic,” Annely M. Richardson, MD, a resident at Baystate Children’s Hospital in Springfield, Massachusetts, told Infectious Diseases in Children. “Three hundred charts were screened, of which 205 met enrollment criteria.”

To control for seasonal disparities, researchers generated the 300 screened charts over four quarters per year and randomly selected them.

Patients who received a WAAP between Jan. 1, 2012 and Dec. 31, 2012 were enrolled in the study and monitored until Dec. 31, 2014. Patients with a comorbid respiratory condition, such as bronchopulmonary dysplasia, and those without a WAAP, were excluded.

Richardson and colleagues documented data on asthma exacerbations requiring hospitalization, ED visits, urgent care visits, and/or steroid prescription. They also collected demographic data on the patients and evaluated the time to first exacerbation by conducting a Kaplan-Meyer survival assessment.

Overall, the median time to first exacerbation was 3.1 years. Monthly exacerbation incidence was 1.2% (95% CI, 1.4-2.2) or 21.6% (95% CI, 17.2-27) annually. A high level of variability was present for the time to a subsequent WAAP in subgroup analyses.

“Data trends suggest a short-term improvement in asthma exacerbation rate in the 6- to 12-month period following WAAP distribution which did not continue at more than 12 months,” Richardson said. “Our findings support [National Heart, Lung, and Blood Institute] guidelines recommending frequent follow-up, including every 3 to 6 months for well-controlled asthma.” – by Alaina Tedesco 

Reference:

Richardson AM, et al. Abstract 3881.724. Presented at: Pediatric Academic Societies Meeting; April 30-May 3, 2016; Baltimore.

Disclosure: The researchers report no relevant financial disclosures.