Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. S96-S105 (doi:10.1542/peds.2005-2000G)
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 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 Google Scholar
Google Scholar
Right arrow Articles by Lenhardt, R. O.
Right arrow Articles by Weiss, K. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lenhardt, R. O.
Right arrow Articles by Weiss, K. B.
Related Collections
Right arrow Asthma

SUPPLEMENT ARTICLE

Improving Pediatric Asthma Care Through Surveillance: The Illinois Emergency Department Asthma Collaborative

Richard O. Lenhardt, MD, MPHa, Catherine D. Catrambone, DNSc, RNb, Michael F. McDermott, MDc, James Walter, MDd, Seymour G. Williams, MDe and Kevin B. Weiss, MDf,g

a Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
b College of Nursing, Rush University Medical Center, Chicago, Illinois
c John H. Stroger, Jr, Hospital of Cook County, Chicago, Illinois
d Section of Emergency Medicine, University of Chicago, Chicago, Illinois
e Centers for Disease Control and Prevention, Atlanta, Georgia
f Institute for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois
g Midwest Center for Health Services and Policy Research and Hines Veterans Affairs Hospital, Hines, Illinois

OBJECTIVES. To better understand and improve the care of asthma patients who require emergency department (ED) care, the Illinois Emergency Department Asthma Collaborative (IEDAC) was created to develop, test, and disseminate an ED-based surveillance system. This report describes the development and testing of the pediatric IEDAC surveillance instruments and demonstrates how these instruments can be used to describe the health status, healthcare delivery, and outcome of children using ED services.

METHODS. A convenience sample of 128 children presenting to 5 EDs in Illinois for asthma care was the study base. Data were collected on monthly samples of children aged 2 through 17 years who presented to these EDs from May to November 2003. Three instruments were used to collect data regarding the children’s pre-ED, ED, and post-ED experience.

RESULTS. At the ED visit, 73.4% of children met national guideline criteria for persistent-level asthma symptoms. Among this group, 53.2% were using inhaled corticosteroid (ICS) medications. At 1 month follow-up, 66.6% of the children met the criteria for persistent-level asthma symptoms, which was statistically unchanged from the ED visit. Among the latter group, 64.2% were using ICS medications, again statistically unchanged compared with the ED visit. At follow-up, 24.5% of children were reported to have returned to an ED or were subsequently hospitalized. The majority of children were noted at follow-up to have limitation of at least some activity.

CONCLUSIONS. Children who presented to IEDAC EDs were found to have a high level of asthma burden that continued at follow-up despite treatment. Moreover, a substantial proportion of children had returned to an ED or were subsequently hospitalized. Encouraging trends in medication use were observed, although suboptimal medication use was also observed.

Key Words: asthma surveillance • emergency department • children

Abbreviations: ED—emergency department • EPR-2—National Asthma Education and Prevention Program Expert Panel Report 2 • IEDAC—Illinois Emergency Department Asthma Collaborative • ICS—inhaled corticosteroid • IQR—interquartile range • MDI—metered-dose inhaler

Accepted Dec 6, 2005.




This article has been cited by other articles:


Home page
 ChestHome page
E. T. Naureckas and S. Thomas
Are We Closing the Disparities Gap?: Small-Area Analysis of Asthma in Chicago
Chest, November 1, 2007; 132(5_suppl): 858S - 865S.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. J. Shannon, C. D. Catrambone, and L. Coover
Targeting Improvements in Asthma Morbidity in Chicago: A 10-Year Retrospective of Community Action
Chest, November 1, 2007; 132(5_suppl): 866S - 873S.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. M. Butz, M. Tsoukleris, M. Donithan, V. D. Hsu, K. Mudd, I. H. Zuckerman, and M. E. Bollinger
Patterns of Inhaled Antiinflammatory Medication Use in Young Underserved Children With Asthma
Pediatrics, December 1, 2006; 118(6): 2504 - 2513.
[Abstract] [Full Text] [PDF]