In pediatric patients with asthma, one of the goals of an asthma management plan should be a referral to an asthma specialist, according to a retrospective study published in the Journal of Asthma and Allergy.
The Asthma Education Program Expert Panel and the Global Strategy for Asthma Management and Prevention both recommend asthma specialist referral for patients older than 5 years. While data have demonstrated that this intervention in adults helps to decrease hospitalization rates and achieve a better level of asthma control, not much information is available on its effect in children.
To address this void of information, researchers in Israel evaluated the effect of asthma specialists’ intervention on asthma control in a large pediatric population from 2000 through 2016. Asthma outcomes during the 2 years before and after a visit to a specialist were compared. During this time period, 37,066 children were diagnosed with asthma, and among them, 13,533 (36.5%) had at least 1 visit to an asthma specialist. The researchers found that children with asthma tended to visit their primary care physician more often before the specialist visit (P <.01), and that after the specialist visit, the average number of emergency department visits, all cause hospitalizations, and hospitalizations due to asthma exacerbations decreased (P <.01 for all comparisons). The researchers also found that after the specialist visit, the number of prescriptions for short-acting beta agonists (P <.01) and corticosteroids ( P<.01) decreased, and the number of inhaled steroid prescriptions increased (P <.01).
“In conclusion, we demonstrated, a significant positive outcome of a single consultation with an asthma specialist, in a large cohort of children with asthma,” stated the researchers. They added, “Referring pediatric asthma patients to an asthma specialist should be one of the goals of an asthma management plan.”
Rosman Y, Gabay L, Landau T, Confino-Cohen R. Childhood asthma – the effect of asthma specialist intervention on asthma control: a retrospective review. J Asthma Allergy. 2021;14:1367-1373. doi:10.2147/JAA.S334560