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American Academy of Pediatrics
Article

Heterogeneity in Asthma Care in a Statewide Collaborative: the Ohio Pediatric Asthma Repository

Jocelyn M. Biagini Myers, Jeffrey M. Simmons, Carolyn M. Kercsmar, Lisa J. Martin, Valentina V. Pilipenko, Stephen R. Austin, Mark A. Lindsey, Katharine M. Amalfitano, Theresa W. Guilbert, Karen S. McCoy, Shalini G. Forbis, John T. McBride, Kristie R. Ross, Pierre A. Vauthy and Gurjit K. Khurana Hershey
Pediatrics February 2015, 135 (2) 271-279; DOI: https://doi.org/10.1542/peds.2014-2230
Jocelyn M. Biagini Myers
Divisions of aAsthma Research,
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Jeffrey M. Simmons
bHospital Medicine,
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Carolyn M. Kercsmar
cPulmonary Medicine, and
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Lisa J. Martin
dHuman Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
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Valentina V. Pilipenko
dHuman Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
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Stephen R. Austin
Divisions of aAsthma Research,
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Mark A. Lindsey
Divisions of aAsthma Research,
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Katharine M. Amalfitano
Divisions of aAsthma Research,
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Theresa W. Guilbert
cPulmonary Medicine, and
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Karen S. McCoy
eDivision of Pediatric Pulmonology, Nationwide Children’s Hospital, Columbus, Ohio;
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Shalini G. Forbis
fDepartment of Pediatrics, Dayton Children’s Hospital, Dayton, Ohio;
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John T. McBride
gDepartment of Pulmonary Medicine, Akron Children’s Hospital, Akron, Ohio;
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Kristie R. Ross
hDepartment of Pediatrics-Pulmonary, Rainbow Babies and Children’s Hospital, Cleveland, Ohio; and
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Pierre A. Vauthy
iDepartment of Pediatric Pulmonary Medicine, ProMedica Toledo Children’s Hospital, Toledo, Ohio
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Gurjit K. Khurana Hershey
Divisions of aAsthma Research,
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Abstract

BACKGROUND AND OBJECTIVE: Asthma heterogeneity causes difficulty in studying and treating the disease. We built a comprehensive statewide repository linking questionnaire and medical record data with health outcomes to characterize the variability of clinical practices at Ohio children’s hospitals for the treatment of hospitalized asthma.

METHODS: Children hospitalized at 6 participating Ohio children’s hospitals for asthma exacerbation or reactive airway disease aged 2 to 17 were eligible. Medical, social, and environmental histories and past asthma admissions were collected from questionnaires and the medical record.

RESULTS: From December 2012 to September 2013, 1012 children were enrolled. There were significant differences in the population served, emergency department and inpatient practices, intensive care unit usage, discharge criteria, and length of stay across the sites (all P < .0001, total n = 1012). Public insurance was highest in Cleveland and Cincinnati (72 and 65%). In the emergency department, Cincinnati and Akron had the highest intravenous magnesium sulfate use (37% and 33%); Columbus administered the most intramuscular epinephrine (15%). Cleveland and Columbus had the highest intensive care unit admittance (44% and 41%) and proportion of long-stay patients (95% and 85%). Moderate/severe asthma severity classification was associated with discharge prescription for inhaled corticosteroids (odds ratio = 2.7; 95% confidence interval: 1.6–4.5; P = .004) but not stay length.

CONCLUSIONS: These data highlight the need for standardization of treatment practices for inpatient asthma care. There is considerable opportunity for personalized care plans that incorporate a patient’s asthma impairment, risk, and treatment response history into hospital practices for asthma exacerbation treatment. The Ohio Pediatric Asthma Repository is a unique statewide resource in which to conduct observational, comparative effectiveness, and ultimately intervention studies for pediatric asthma.

  • inpatient asthma
  • children
  • repository
  • clinical practices
  • Accepted November 13, 2014.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 135, Issue 2
1 Feb 2015
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Heterogeneity in Asthma Care in a Statewide Collaborative: the Ohio Pediatric Asthma Repository
Jocelyn M. Biagini Myers, Jeffrey M. Simmons, Carolyn M. Kercsmar, Lisa J. Martin, Valentina V. Pilipenko, Stephen R. Austin, Mark A. Lindsey, Katharine M. Amalfitano, Theresa W. Guilbert, Karen S. McCoy, Shalini G. Forbis, John T. McBride, Kristie R. Ross, Pierre A. Vauthy, Gurjit K. Khurana Hershey
Pediatrics Feb 2015, 135 (2) 271-279; DOI: 10.1542/peds.2014-2230

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Heterogeneity in Asthma Care in a Statewide Collaborative: the Ohio Pediatric Asthma Repository
Jocelyn M. Biagini Myers, Jeffrey M. Simmons, Carolyn M. Kercsmar, Lisa J. Martin, Valentina V. Pilipenko, Stephen R. Austin, Mark A. Lindsey, Katharine M. Amalfitano, Theresa W. Guilbert, Karen S. McCoy, Shalini G. Forbis, John T. McBride, Kristie R. Ross, Pierre A. Vauthy, Gurjit K. Khurana Hershey
Pediatrics Feb 2015, 135 (2) 271-279; DOI: 10.1542/peds.2014-2230
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