Document Detail

Trigger recognition and management in poorly controlled asthmatics.
MedLine Citation:
PMID:  20977834     Owner:  NLM     Status:  MEDLINE    
Previous studies using cross-sectional designs suggest that asthma trigger recognition and management are suboptimal in clinical practice. The objective of this study was to assess gaps between asthma guideline recommendations and clinical practice regarding asthma trigger recognition and management by tracking poorly controlled asthma patients over a 2-year period. A retrospective cohort study of a representative sample of 102 children and adult residents of Olmsted County, MN, with poor asthma control in 2003-2004 was performed. All medical records from each asthma-related visit were examined for documented asthma trigger inquiries, specific trigger avoidance advice, and for adherence to the trigger avoidance advice. One hundred two subjects made 686 asthma-related visits that were included for analysis. At least 1 trigger inquiry occurred in 83% of visits, with an average of 2.0 triggers queried per visit. The most common trigger inquiries were for infection (47%), environmental tobacco smoke (41%), and allergens (29%). The mean number of triggers queried was higher during exacerbation visits versus nonexacerbation visits (2.1 versus 1.8; p < 0.001) and in the emergency care settings compared with outpatient settings (2.4 versus 1.7; p < 0.001). Advice for managing asthma triggers was given in 30% of visits and adherence to trigger advice was evaluated at 6% of visits. Future interventions for improving asthma trigger management should be targeted to routine asthma outpatient visits, where trigger avoidance advice is infrequent and rarely addressed in follow-up visits.
Matthew A Rank; Peter Wollan; James T Li; Barbara P Yawn
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-25
Journal Detail:
Title:  Allergy and asthma proceedings : the official journal of regional and state allergy societies     Volume:  31     ISSN:  1539-6304     ISO Abbreviation:  Allergy Asthma Proc     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2011-06-28     Completed Date:  2011-11-01     Revised Date:  2014-09-11    
Medline Journal Info:
Nlm Unique ID:  9603640     Medline TA:  Allergy Asthma Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-105     Citation Subset:  IM    
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MeSH Terms
Advance Directive Adherence* / statistics & numerical data
Asthma / epidemiology*,  immunology*,  physiopathology
Cohort Studies
Delivery of Health Care
Follow-Up Studies
Immunization* / statistics & numerical data
Patient Education as Topic
Practice Guidelines as Topic*
Retrospective Studies
Grant Support
R01 AG034676/AG/NIA NIH HHS; R01 AG034676-47/AG/NIA NIH HHS; R01 AR030582/AR/NIAMS NIH HHS; R01 AR030582-43/AR/NIAMS NIH HHS; R01 AR30582/AR/NIAMS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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