Despite guidelines, half of children with asthma do not receive a management plan
SAN DIEGO — Despite an increase in the percentage of children with persistent asthma who have received a written asthma management plan, 49% of patients still did not receive one, with significant variations by race and insurance status.
In 1997, the National Asthma Guidelines recommended that all asthma patients receive a written asthma management plan that provides instruction on how to manage asthma daily, including appropriate medications; identifying specific allergens that can prompt asthma symptoms; recognizing worsening asthma and seeking emergency care.
To evaluate whether the proportion of children with asthma with a current asthma action plan has improved over time, and if differences exist between sociodemographic groups, Alan E. Simon, MD, from the office of Analysis and Epidemiology at the National Center for Health Statistics, and colleagues analyzed National Health Interview Survey data from 2002, 2003, 2008, and 2013 for children aged 2-17 years (n = 3,833) with current asthma.
Children younger than 2 years were excluded due to diagnostic confusion in distinguishing asthma from bronchiolitis. Parents reported whether the child had ever received an asthma action/management plan from a doctor.
To assess trends among children in different socioeconomic and demographic groups, the researchers used bivariate logistic regression models with receipt of an asthma action plan as the dependent variable and year as the independent variable. In addition, Simon and colleagues conducted multivariable logistic regression for 2013 only, to examine the independent effect of each sociodemographic factor, including sex, race and ethnicity, insurance status, percentage of family poverty level and urban and rural status.
According to study results, the percentage of children with current asthma who received a written asthma action plan increased from 41% in 2002 to 51% in 2013: approximately 0.9% per year (P < .001 for trend).
Simon and colleagues observed that non-Hispanic black children were more likely than non-Hispanic white children to receive a written management plan (59% vs. 47%, P < .05), while children with private health insurance were more likely than those covered by public insurance to receive a plan (56% vs. 47%, P < .05).
When compared to children residing in large central metropolitan areas, researchers found that children with asthma in micropolitan and non-centralized areas were less likely to receive a plan (40% vs 54%, P < .05).
“The national asthma education and prevention program guidelines recommend that every patient with asthma have an asthma action plan. Indeed, the drafters of these suggested this was one of the six key messages of the guidelines,” Simon told Infectious Diseases in Children. “Although the percentage of children with asthma that reported having an action plan has increased over time, approximately half of children with asthma still do not have an action plan. There is still ample room for improvement.”– by Bob Stott
Simon AE. Abstract #2851.11. Presented at: Pediatric Academic Societies 2015; April 25-28, 2015; San Diego.
Disclosures: The researchers report no relevant financial disclosures.