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Prescription habits for preventative medications among pediatric emergency department physicians at an inner-city teaching hospital.

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Title: Prescription habits for preventative medications among pediatric emergency department physicians at an inner-city teaching hospital.
Authors: Lovinsky, S. (AUTHOR), Rastogi, D. (AUTHOR)
Source: Journal of Asthma. Nov2010, Vol. 47 Issue 9, p1011-1014. 4p. 2 Graphs.
Subjects: Pediatric emergency services, Teaching hospitals, Emergency medical services, Asthma in children, Steroids
Abstract: Introduction. As asthma presentation is episodic, patients with acute exacerbations often present in the emergency department (ED) where preventative regimen may not always be addressed. Addressing initiation and modification of controller medications in the setting of an acute exacerbation may facilitate improved asthma control and decrease the frequency of ED visits, particularly so for families who receive most of their asthma management in the ED. However, this aspect has not yet been explored. Methods. We reviewed a random sample of 363 charts, 10% of the total number of asthmatic children, aged 2-18, seen from January to December 2007 in the pediatric ED of an urban teaching hospital located in Bronx, NY, USA. We quantified the frequency of modification of the preventative regimen and the influence of seasons on this practice. Results. Of these 363 children, 42.4% of patients were not previously on a controller medication. Of these, 9.7% were started on a new controller medication, with a significantly higher percent occurring in the summer months. Of those that were previously on a controller medication, 2.87% were started on a new controller medication and 0.95% had their controller medication dose increased. However, the regimen was not adjusted in 14.3% that had been seen four or more times in the preceding 2 years. Of the total 363 children, 78.5% were discharged from the ED on a short course of oral steroids, and this was not part of their preventative regimen. Only four charts had physician-documented asthma severity classification. Conclusions. We found that the preventative regimen was modified in only 0.9-2% of all asthmatic children seen in an urban ED whereas 78.5% were started on systemic steroids. Asthma severity was evaluated in a very small number of patients. Because modification of preventative regimen requires appropriate asthma severity classification, the inclusion of asthma severity classification as part of routine ED evaluation may encourage physicians to address controller medications in persistent asthmatics. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Asthma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Prescription habits for preventative medications among pediatric emergency department physicians at an inner-city teaching hospital.
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  Data: <searchLink fieldCode="AR" term="%22Lovinsky%2C+S%2E%22">Lovinsky, S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rastogi%2C+D%2E%22">Rastogi, D.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Asthma%22">Journal of Asthma</searchLink>. Nov2010, Vol. 47 Issue 9, p1011-1014. 4p. 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Pediatric+emergency+services%22">Pediatric emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+hospitals%22">Teaching hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medical+services%22">Emergency medical services</searchLink><br /><searchLink fieldCode="DE" term="%22Asthma+in+children%22">Asthma in children</searchLink><br /><searchLink fieldCode="DE" term="%22Steroids%22">Steroids</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Introduction. As asthma presentation is episodic, patients with acute exacerbations often present in the emergency department (ED) where preventative regimen may not always be addressed. Addressing initiation and modification of controller medications in the setting of an acute exacerbation may facilitate improved asthma control and decrease the frequency of ED visits, particularly so for families who receive most of their asthma management in the ED. However, this aspect has not yet been explored. Methods. We reviewed a random sample of 363 charts, 10% of the total number of asthmatic children, aged 2-18, seen from January to December 2007 in the pediatric ED of an urban teaching hospital located in Bronx, NY, USA. We quantified the frequency of modification of the preventative regimen and the influence of seasons on this practice. Results. Of these 363 children, 42.4% of patients were not previously on a controller medication. Of these, 9.7% were started on a new controller medication, with a significantly higher percent occurring in the summer months. Of those that were previously on a controller medication, 2.87% were started on a new controller medication and 0.95% had their controller medication dose increased. However, the regimen was not adjusted in 14.3% that had been seen four or more times in the preceding 2 years. Of the total 363 children, 78.5% were discharged from the ED on a short course of oral steroids, and this was not part of their preventative regimen. Only four charts had physician-documented asthma severity classification. Conclusions. We found that the preventative regimen was modified in only 0.9-2% of all asthmatic children seen in an urban ED whereas 78.5% were started on systemic steroids. Asthma severity was evaluated in a very small number of patients. Because modification of preventative regimen requires appropriate asthma severity classification, the inclusion of asthma severity classification as part of routine ED evaluation may encourage physicians to address controller medications in persistent asthmatics. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Asthma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=55043088
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        Value: 10.1080/02770903.2010.491138
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        Text: English
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        Type: general
      – SubjectFull: Teaching hospitals
        Type: general
      – SubjectFull: Emergency medical services
        Type: general
      – SubjectFull: Asthma in children
        Type: general
      – SubjectFull: Steroids
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              Text: Nov2010
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