Published online March 1, 2006
PEDIATRICS Vol. 117 No. 3 March 2006, pp. 821-827 (doi:10.1542/peds.2005-0962)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Scarfone, R. J.
Right arrow Articles by Angsuco, C. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Scarfone, R. J.
Right arrow Articles by Angsuco, C. J.
Related Collections
Right arrow Asthma

Emergency Physicians' Prescribing of Asthma Controller Medications

Richard J. Scarfone, MD, FAAPa,b, Joseph J. Zorc, MDa,b and Cherrie J. Angsucob

a Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
b Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

OBJECTIVES. To determine the frequency with which emergency department (ED) physicians prescribe long-term controller medications (LTCMs) for children with asthma, to assess ED physicians' awareness of and level of agreement with national guidelines for LTCM use, and to identify criteria ED physicians use to prescribe LTCMs and barriers to the use of LTCMs.

METHODS. A survey of all physician members of the American Academy of Pediatrics Section on Emergency Medicine who provide care for children in an ED was performed.

RESULTS. Surveys were returned by 391 (50%) of 782 physicians. The majority (80%) indicated that fewer than one half of children with persistent asthma were using LTCMs on ED arrival. Although 99% believe that children with persistent asthma should be treated with LTCMs, <20% provide LTCMs for the majority of such children at ED discharge. For 49%, the main reason for not prescribing these medications was the belief that this was the role of the primary care provider or asthma specialist. Practice setting, prior training, and annual patient volume were not associated significantly with prescribing LTCM. Patient's age and likelihood of compliance and physician's belief in efficacy and concerns about adverse effects were not important criteria in the decision to begin LTCM.

CONCLUSIONS. ED physicians often encounter children with persistent asthma who are not receiving LTCMs, they believe in the efficacy and safety of LTCMs, and they think that children with persistent disease should be treated with LTCMs, but they prescribe LTCMs infrequently.

Key Words: long-term controller medication • emergency department • asthma

Abbreviations: LTCM—long-term controller medication • ED—emergency department • NAEPP—National Asthma Education and Prevention Program • ICS—inhaled corticosteroid • AAP—American Academy of Pediatrics • PCP—primary care provider • PEM—pediatric emergency medicine

Accepted Jul 19, 2005.




This article has been cited by other articles:


Home page
 J Clin PharmacolHome page
A. Zuppa, S. Vijayakumar, B. Jayaraman, D. Patel, M. Narayan, K. Vijayakumar, J. T. Mondick, and J. S. Barrett
An Informatics Approach to Assess Pediatric Pharmacotherapy: Design and Implementation of a Hospital Drug Utilization System
J. Clin. Pharmacol., September 1, 2007; 47(9): 1172 - 1180.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
H. K. Lehman, K. A. Lillis, S. H. Shaha, M. Augustine, and M. Ballow
Initiation of Maintenance Antiinflammatory Medication in Asthmatic Children in a Pediatric Emergency Department
Pediatrics, December 1, 2006; 118(6): 2394 - 2401.
[Abstract] [Full Text] [PDF]