Alert Reminds Emergency Providers to Consider Asthma Controller Medication

An electronic alert prompting emergency providers at a children’s hospital to prescribe asthma controller medication for patients with poorly controlled asthma was effective, according to a study published online in the Journal of Asthma.

The study included children ages 4 through 14 presenting to the emergency department at Phoenix Children’s Hospital with at least two previous emergency department visits for acute exacerbation of asthma within the past year, no active prescription for inhaled corticosteroids within 90 days, and free from developmental delay, bronchopulmonary dysplasia due to prematurity, cystic fibrosis, sickle cell disease, and/or interstitial ling disease.

“Patients meeting these criteria triggered an electronic alert prompting the medical provider to prescribe inhaled corticosteroids or indicate reason for not prescribing,” researchers explained.

Among 62 children discharged from the emergency department between February 9, 2018, and December 4, 2018, 77% received a prescription for inhaled corticosteroids, researchers found. Prescriptions were issued by 56% of physicians and 42% of residents prompted by the electronic alert.

For a third of children discharged without a prescription for inhaled corticosteroids, no reason was given for the lack of a prescription, according to the study. Researchers could detect no statistically significant differences in baseline characteristics between patients discharged with and without a prescription.

“Additional data describing reasons for not prescribing inhaled corticosteroids can further refine recommendations for inhaled corticosteroids prescriptions,” they concluded, “and provide a comprehensive strategy to support clinical decision for pediatric asthma control in acute care settings.”

—Jolynn Tumolo

Reference

Farmer A, Mirea L, Carter J, et al. Inhaled corticosteroids prescriptions increased in the ED for recurrent asthma exacerbations by automated electronic reminders in the ED [Published online July 8, 2019]. J Asthma. 2019 Jul 8:1-5. doi: 10.1080/02770903.2019.1635152