Effort to improve kids’ asthma care falls short
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For inner-city kids with Asthma, a school-based initiative to let their doctors know about the severity of the children’s asthma didn’t seem to make much difference, New York researchers report.
“Unfortunately,” Dr. Jill S. Halterman told Reuters Health, “provider notification of symptoms did not increase the likelihood of these children receiving enhanced preventive care, and many of the children were still inadequately treated at follow-up.”
Halterman, at Golisano Children’s Hospital at Strong, Rochester, and colleagues note in the Archives of Pediatrics and Adolescent Medicine that young urban children with Asthma often receive inadequate therapy. This may in part be due to primary care providers not being aware of the severity of their patients’ symptoms.
In an attempt to enhance preventative therapy, the team identified 151 children between 3 to 7 years old with mild to severe asthma.
They were randomly assigned to an intervention group in which the child’s primary care physician was sent a fax describing the patient’s symptoms and recommending appropriate medication, based on national guidelines. No such notification was sent for kids in the comparison “control” group.
After 3 to 6 months, parents were contacted and asked what preventative measures had been taken.
Compared with the controls, the intervention group was not significantly more likely receive preventative medication.
In addition, there were no significant differences between the two groups in the encouragement given to kids and parents to stick with their medication, in improvements in the children’s environmental, or referrals to specialists.
“At the end of the study,” the researchers report, “52.4 percent of children in both groups with no medication changes were still experiencing persistent symptoms.”
It appears, concluded Halterman, “that solving the problem of undertreatment for asthma requires more than the transfer of information about symptom severity, and more intensive interventions may be needed.”
SOURCE: Archives of Pediatrics and Adolescent Medicine, May 2005.
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