Increased Use of Inhaled Corticosteroids, Visits to Allergist Result in Fewer Emergency Room Visits for Asthma Patients

By Ed Susman

DENVER, CO -- March 11, 2003 -- Patients with asthma who make frequent use of inhaled corticosteroids and visit allergy specialists regularly spend less time in emergency rooms, researchers reported.

"There was a 36% relative risk reduction in emergency hospital utilization among patients who used more than 6 canisters of inhaled steroids during the previous year," said Michael Schatz, MD, chief of the allergy department at Kaiser-Permanente Medical Center, San Diego.

"There was a 27% relative risk reduction in emergency hospital utilization among patients who were ever treated by an allergist," Dr. Schatz also reported here March 10^th at the 60^th Annual Meeting of the American Academy of Allergy, Asthma and Immunology.

In the study, Dr. Schatz reviewed records of 9,608 asthmatic patients age 3-64 years, who were continuously enrolled at Kaiser-Permanente, San Diego in 1999 and 2000. Patients were considered to have been seen by an allergist if they were seen in the Kaiser health maintenance organization's Allergy Department in 1999.

Dr. Schatz, who is also a clinical professor of medicine at the University of California, San Diego, said emergency department use decreased as patients increased their use of inhaled steroids, but a dramatic decrease in visits to the hospital for asthma emergencies decreased the greatest when patients achieved optimal inhaled corticosteroid therapy -- more than 6 canisters of inhaled steroids in 1999.

The results show that 4.7% of patients required emergency hospital care -- either a trip to the emergency room or a hospitalisation for asthma symptoms -- during 2000. A higher percentage of patients -- 24.7% -- who had seen an allergist achieved optimal inhaled steroid therapy than patients who did not see the specialized allergy staff -- 8.3% -- a difference that reached statistical significance at the p<0.001.

However, the combination of visiting an allergist and using more than 6 canisters of inhaled steroids, while associated with fewer hospital visits, achieved only borderline significance.


[Study title: Use of Inhaled Corticosteroids and Allergy Specialty Care Reduce Emergency Hospital Use By Asthma Patients. Abstract 834]