Source: International Congress 2016 – Monitoring airway diseases with clinical tools
Disease area: Airway diseases

Abstract

Leeds is a large urban city served by 2 ED with an above average rate of asthma admissions. The aim of this study was to characterise the population with ED attendance not already known to specialist services.We retrospectively reviewed all patients attending the ED with a diagnosis of acute asthma between 01/01–31/03/2015. The shared health care record was reviewed to determine the frequency of oral corticosteroids, hospital attendance, asthma treatment stage and whether specialist review had occurred.During the study period 223 attendances were identified by 196 individuals. The majority of these attendances (80%), were self-referrals to the ED of whom the majority were subsequently discharged directly from the ED. Two thirds of the people had never received a specialist asthma assessment. During the study period 57 (29%) individuals, were identified as needing specialist review on the basis of being at step 3 or 4 of the BTS guidelines and/or multiple asthma ED attendance in the preceding 12 months.This study identified a population of people with significant evidence of poor asthma control, managed in primary care and using the ED for management of exacerbations. These exacerbations were not severe enough to warrant admission, with subsequent routine specialist review. Subsequently, we have implemented a systematic review of shared health care records for all ED asthma attendances, with communication to primary care advising asthma review +/- specialist referral on the basis of asthma step / exacerbation frequency. We would suggest close working with colleagues in the ED to ensure robust systems are in place to identify people with asthma at potential high risk of future exacerbations.


Rating:

Share or cite this content

Citations should be made in the following way:
Ian Clifton (Sherburn-In-Elmet, United Kingdom), Sarah Smart, Louise Carefoot, Anin Dasgupta, Tim Sutherland, Ian Clifton. Emergency department (ED) attendance with asthma: An unmet need for specialist review. Eur Respir J 2016; 48: Suppl. 60, 1037

Member's Comments

No comment yet.

Related content which might interest you: Does increasing the access to specialist respiratory team reduce the presentation and admission of acute asthma to hospital? Source: International Congress 2016 – Non-inflammatory assessment of airway disorders Year: 2016 Are acute asthma admissions preventable with improved patient education? Source: Annual Congress 2013 –Treatment and management of asthma in primary care Year: 2013 Comparative audit of asthma management in the easy asthma clinic and general out-patient clinic Source: International Congress 2015 – Management of asthma and COPD in primary care Year: 2015 The role of specialist nurse led review on reducing emergency asthma admissions in a district general hospital (DGH) Source: International Congress 2015 – Non-inflammatory monitoring of airway diseases Year: 2015 Does having specialist asthma nurses improve adherence to national asthma guidelines? A comparison between two UK district general hospitals Source: International Congress 2015 – Chronic airway disorders: miscellaneous aspects Year: 2015 Standard versus patient-centred asthma education in the emergency department: a randomised study Source: Eur Respir J 2008; 31: 990-997 Year: 2008 Reason for non-compliance to inhaled medications among adult patients of asthma and COPD attending outpatient department in a tertiary care hospital Source: International Congress 2016 – Asthma management in primary care Year: 2016 Presentation to the emergency department by breathless patients: A qualitative study Source: International Congress 2016 – Management of asthma and COPD in primary care Year: 2016 COPD: Home visits program after admission with an exacerbation Source: International Congress 2015 – Best abstracts in COPD management Year: 2015 Asthma prescribing practices, ethnicity and risk of hospital admission: An analysis of linked primary and secondary care records in East London Source: International Congress 2016 – Asthma management in primary care Year: 2016 Assessment and management of asthma in the emergency department: are guidelines implemented? Source: Eur Respir J 2001; 18: Suppl. 33, 51s Year: 2001 Description of a Dutch well-established asthma/COPD service for primary care Source: Annual Congress 2013 –Early diagnosis and effectiveness of disease management in primary care Year: 2013 The impact of a structured consultation delivered by a respiratory nurse specialist on patients’ use of personalised asthma action plans (PAAP) Source: International Congress 2016 – Non-inflammatory assessment of airway disorders Year: 2016 Variation in non-elective hospital admission and consequent asthma costs across primary care practice and clinical commissioning group (CCG), Wessex, United Kingdom Source: International Congress 2015 – Management of asthma and other respiratory diseases in primary care Year: 2015 LATE-BREAKING ABSTRACT: Impact of the provision of free medications on hospital admissions for asthma in Brazil Source: International Congress 2015 – Respiratory disease management in primary care Year: 2015 Asthma management in French general practice: Physician-reported medical care and adherence support Source: International Congress 2015 – Respiratory disease management in primary care Year: 2015 The contribution of an asthma diagnostic consultation service (ADCS) in obtaining an accurate asthma diagnosis for primary care patients Source: International Congress 2016 – Asthma management in primary care Year: 2016 Favorable results from a Dutch asthma/COPD service for primary care Source: Annual Congress 2013 –Quality of diagnosis and assessment in primary care Year: 2013 Holistic management of asthma exacerbation in emergency department (ED): A-CARE (Asthma-COPD Afterhours Respiratory Nurse at Emergency) program Source: International Congress 2018 – Asthma management Year: 2018 Parental involvement and tele-monitoring decreases unscheduled outpatient visits in pediatric asthma patients Source: International Congress 2015 – Paediatric asthma and allergy: e-health in management Year: 2015