Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. S159-S166 (doi:10.1542/10.1542/peds.2005-2000N)
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SUPPLEMENT ARTICLE

Commentary: Doing the Most to Ensure the Least Emergency Department Asthma Visits: Asthma Experts Consider Preliminary Project Findings

Abbreviations: CDC, Centers for Disease Control and Prevention • ED, emergency department • PCP, primary care provider • BRFSS, Behavioral Risk Factor Surveillance System

The first 300 words of the full text of this article appear below.

In early January 2005, the American Academy of Allergy, Asthma and Immunology, the Robert Wood Johnson Foundation, and the Centers for Disease Control and Prevention (CDC) hosted an invitational meeting in Atlanta, Georgia, near the CDC headquarters, called "Doing the Most to Result in the Least: ED [emergency department] Asthma Visits." Project investigators, select clinicians, researchers, public health experts, insurers, and policy makers learned about the preliminary findings of the CDC and Robert Wood Johnson Foundation projects, some of which are presented herein, and considered their potential impact on clinical practices, health care delivery, and health care policies.

The following commentary reflects the thoughts and opinions of individual meeting participants based on their own experiences as well as the projects’ preliminary findings; they should not be construed as endorsements by participants’ affiliated organizations. Comments and recommendations were made in hope that a number of audiences would find them thought provoking and useful.


   APPROPRIATE ROLE OF THE ED IN MANAGING CHILDHOOD ASTHMA
 
Asthma is a complex and chronic disease. Although it cannot be cured, long-term treatment can keep asthma symptoms well under control. Elements of effective, long-term asthma treatment include an accurate diagnosis, continuous assessment of severity, prescribing severity-appropriate medications, and teaching and reinforcing patient- and family-centered asthma management techniques. Children who seek ED care for asthma exacerbations may lack connection with a health care provider system that consistently delivers all the elements of asthma treatment necessary for preventing acute exacerbations and ED admissions for asthma.1–3 Although more research is needed to determine how to best ensure that children with asthma are connected with a long-term care system that delivers all the elements of effective care, the problem itself begs some important health policy questions: Can and should the ED expand its asthma management role beyond the episodic treatment of acute exacerbations? If so, what should this extended role look . . . [Full Text of this Article]


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Related articles in Pediatrics:

Introduction:Enhancing the Role of the Emergency Department in the Identification and Management of Childhood Asthma
Gary S. Rachelefsky, Suzanne Kennedy, and Amy Stone
Pediatrics 2006 117: S57-S62. [Extract] [Full Text]