1117 Asthma education and medication compliance are associated with emergency department visits by asthmatic children

Sunday, 7 December 2014
Exhibition Hall-Poster Area (Sul America)

Saleh Al Muhsen, MD , Pediatrics, 1Asthma Research Chair and Prince Naif Center for Immunology Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Alejandro Vazquez-Tello, PhD , Prince Naif Center for Immunology Research, College of Medicine, King Saud University, Saudi Arabia

Hamdan Al-Jahdali, MD , 3Department of Medicine, Pulmonary Division-ICU, King Saud University for Health Sciences, Riyadh, Saudi Arabia, Saudi Arabia

Rabih Halwani, PhD , 1Asthma Research Chair and Prince Naif Center for Immunology Research, Department of Pediatrics, College of Medicine, King Saud University, Saudi Arabia

Background. Asthma is the most frequent chronic pulmonary disorder in children from Saudi Arabia. Acute exacerbations of bronchial asthma remain the major cause of frequent Emergency Department (ED) visits. However, psychosocial, behavioral and educational factors are also reportedly associated with repetitive ED visits by asthmatic children. In Saudi Arabia, few studies have  investigated the nature, frequency and impact of these factors on ED frequency of visits.

Objective. To analyze potential risk factors for their possible association with increased frequency of visits to ED, to outpatient clinics, and of hospital admissions by asthmatic children.

Methods. Asthmatic children (n=289) aged 7-17 years old were interviewed at the time of visiting an ED facility at two major hospitals in a period of one year. Data regarding education and awareness of asthma disease, use of medications, therapy devices, environmental factors, and  reasons for visiting an ED were collected. The effect of these factors on the decision of asthmatic patients to visit ED were then investigated.

Results.  Recruited patients visited an ED 3.9±3.2 times per year on average, more than the primary care facility (2.6±3.0). Most patients had intermittent (63.5%) or mild symptoms (27.6), and the majority (73.5%) had their symptoms well controlled. Several asthma education-related factors significantly affected visits to ED and the outpatient clinic, which included instructions about asthma disease, medicines and inhaler use, as well as ways to prevent and treat symptoms. Environmental factors, asthma severity classification, and other reasons for visiting the ED were significantly associated with frequency of hospital admissions, but not with ED visits. Schooling levels and asthma control scores had no significant effect.

Conclusion. Our study indicated that most ED visits by asthmatic children were not for the purpose of treatment against asthma exacerbations. Patients with both better education and awareness  about asthma disease visited more frequently the ED and the outpatient clinic. It also revealed that most of the patients were not using medications properly, suggestive of inefficient management of symptoms at home. This indicates the necessity to improve the education about the disease and medication to both patients and their parents/guardians leading to the proper usage of medical facilities.