Kids who get prescription asthma drugs visit ER less often

Updated 1:00 PM May 19, 2003

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Kids who get prescription asthma drugs visit ER less often

By Kara Gavin
UMHS Public Relations

An ounce of prevention may really be worth a pound of cure for children with asthma, a new U-M Health System (UMHS) study shows.

Children who have prescriptions for one or more asthma drugs–which aim to prevent or calm asthma attacks–have fewer visits to the emergency room for asthma than those who haven't been prescribed such medications, the study finds.

But the research also reveals that asthmatic African American and urban children rush to the ER more frequently than other kids because of an asthma attack.

U-M pediatric researchers presented the findings at the annual joint meeting of the Pediatric Academic Societies in Seattle May 6, which also was World Asthma Day. The study is based on data from more than 19,000 children with asthma who were enrolled in Michigan's Medicaid program in the year 2001.

The researchers looked at the frequency of children's asthma-related ER visits, and how rates of ER visits vary by age, gender, race, urban location, disability status and prescriptions for fast-acting "rescue" medications as well as long-term preventive asthma drugs. Sixteen percent of the children had no prescription for a rescue drug.

"We found that use of asthma medications was directly associated with lower rates of ER visits for asthma, and that those kids who have no prescriptions on record are more frequent visitors to the emergency department," says U-M pediatric research investigator and lead author Kevin Dombkowski.

He continues, "Although we couldn't peer into these children's homes to see if they were actually using their inhalers, we hope this study will help prompt increased awareness of how long-term management of asthma can be achieved through appropriate use of medications, and studies to further evaluate the effect of medication use on ER visits."

Dombkowski conducted the study with colleagues from the U-M Child Health Evaluation and Research (CHEAR) unit, part of the Department of Pediatrics and Communicable Diseases in the Medical School, using data provided by the Michigan Department of Community Health (MDCH). He credits the computerized Michigan Medicaid databases for making it possible to perform the population study, which was funded by MDCH.

While the results do not apply directly to children who are privately insured, the researchers say, the data provide preliminary evidence of the association between asthma medication use and ER visits. They also document further racial and geographic differences in asthma care, beyond already-known disparities.

When the researchers performed an analysis that controlled for age, gender, race, urban location and disability status, two statistically significant disparities especially stood out. Black children visited the ER more than twice as often as white children. And urban children visited the ER for asthma-related causes 42 percent more often than non-urban children. Children between the ages of 5 and 9 were the most frequent users of the ER for asthma.

In addition to Dombkowski, the study's authors are assistant professor Dr. Michael Cabana, and research investigator Sarah Clark, associate director for research.

Kids who get prescription asthma drugs visit ER less often

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