Poor treatment leads to emergency room visits

Children who don?t receive proper care to manage their asthma end up in emergency rooms with breathing crises more often, said Arlene Butz, an asthma specialist at the Children?s Center, whose study was published in December issue of Pediatrics.

Failed treatment is not always a factor of lack of access to health care, she said.

“Doctors don?t always get the information” needed to properly treat children, Butz said.

“Communication is a key factor on both sides. The family has to communicate the correct symptoms, the actual medications the child is taking, what?s going on in their home.”

Previous research indicates that inner-city children are at special risk because their living conditions include other asthma triggers, such as exposure to secondhand smoke and mouse and cockroach droppings, according to the study.

The findings are disturbing because preventive therapy failure leads to over-reliance on fast-acting “rescue” inhalers, and to more complications and increased risk of death, the researchers said.

Asthma is the most common long-term disease of the lungs affecting children, according to the Centers for Disease Control and Prevention.

It causes repeated episodes of wheezing, breathlessness, chest tightness and nighttime or early morning coughing.

The Hopkins team interviewed parents of 180 Baltimore City children age 2 to 9, diagnosed with persistent asthma and studied their pharmacy records.

Overall, only 36 used the recommended amount of daily controller medication, which is six or more refills in a 12-month period.

Another 60 percent of children received too little therapy to fully prevent flare-ups.

Twenty percent either got no medication at all or relied solely on quick-relief rescue drugs, which stop an asthma attack from getting worse.

The survey also showed that children cared for by asthma specialists in or out of the hospital were more likely to follow a proper drug regimen than those who were not in these groups.

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