Poowuttikul Pavadee, Hart Benjamin, Thomas Ronald, Secord Elizabeth
Wayne State University, Detroit, MI, USA.
Henry Ford Hospital, Detroit MI, USA.
Glob Pediatr Health. 2017 May 30;4:2333794X17710588. doi: 10.1177/2333794X17710588. eCollection 2017.
Asthma results in significant pediatric hospitalizations in the inner city. Many asthmatic children were admitted to our hospital as a result of lack of medications or medical supplies that had been previously prescribed ("ran out," "broken," or "lost"). To identify the incidence of children admitted for asthma because of lack of prescribed medications/supplies and to assess risk factors for poor adherence between groups. This was a prospective chart review of 200 asthmatic children admitted to Children's Hospital of Michigan, Detroit. The data included asthma severity, lack of prescribed medications/medical supplies, and outpatient management. In all, 35.5% or 71/200 of asthmatic children admitted had lack of prescribed medication/supplies (9% lacked both). The most common deficiency was β2-agonist (20.5%; 41/200). Teenagers had the highest lack of medications/medical supplies (55.6%; 5/9) compared with toddlers (17.2%; 16/93) and preschoolers (17.9%; 5/28). Patients with severe persistent asthma had a higher incidence of lacking medicine (31.8%; 7/22) compared with 25% (14/56) with moderate persistent asthma and 23.4% (15/64) of mild asthmatics. We found the lack of asthma medical supplies, including nonfunctioning or lost nebulizers/spacers, in 44.4% (4/9) of teenagers, 17.2% (16/93) of toddlers, and 21.4% (6/28) of preschool-aged children. We found no significant difference in these deficiencies whether patients were managed by asthma specialists or primary care providers. Significant numbers of asthmatic children admitted reported lack of prescribed medications/medical supplies. The most severe asthmatics were most likely to run out of medications. Interventions targeted at these deficiencies may avoid hospitalizations.
哮喘导致市中心地区大量儿童住院。许多哮喘儿童因之前开具的药物或医疗用品短缺（“用完”、“损坏”或“丢失”）而入住我院。为了确定因缺乏处方药物/用品而入院的哮喘儿童的发生率，并评估不同组之间依从性差的风险因素。这是一项对底特律密歇根儿童医院收治的200名哮喘儿童进行的前瞻性病历回顾。数据包括哮喘严重程度、缺乏处方药物/医疗用品以及门诊管理情况。总共，35.5%（71/200）的入院哮喘儿童缺乏处方药物/用品（9%两者都缺乏）。最常见的短缺药物是β2激动剂（20.5%；41/200）。与幼儿（17.2%；16/93）和学龄前儿童（17.9%；5/28）相比，青少年缺乏药物/医疗用品的比例最高（55.6%；5/9）。重度持续性哮喘患者缺乏药物的发生率较高（31.8%；7/22），中度持续性哮喘患者为25%（14/56），轻度哮喘患者为23.4%（15/64）。我们发现，44.4%（4/9）的青少年、17.2%（16/93）的幼儿和21.4%（6/28）的学龄前儿童存在哮喘医疗用品短缺的情况，包括雾化器/储雾罐无法使用或丢失。我们发现，无论患者是由哮喘专科医生还是初级保健提供者管理，这些短缺情况均无显著差异。大量入院的哮喘儿童报告缺乏处方药物/医疗用品。最严重的哮喘患者最有可能用完药物。针对这些短缺情况的干预措施可能避免住院治疗。
