Documentation of asthma control and severity in pediatrics: analysis of national office-based visits

Sanika Rege, Abhishek Kavati, Benjamin Ortiz, Giselle Mosnaim, Michael D. Cabana, Kevin Murphy, Rajender R. Aparasu

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective: To evaluate the extent of documentation of asthma control and severity and associated characteristics among pediatric asthma patients in office-based settings. Methods: This cross-sectional study utilized data from the 2012–2015 National Ambulatory Medical Care Survey (NAMCS). Patients aged 6–17 years with a diagnosis of asthma were included. Weighted descriptive analysis examined the extent of documentation and uncontrolled asthma; while logistic regression evaluated associated characteristics. Results: Overall, there were 2.47 million (95% confidence interval, 95% CI: 2.04–2.90) average annual visits with asthma as a primary diagnosis. Asthma control and severity was documented in only 36.1% and 33.8% of the visits, respectively. An established patient (odds ratio, OR = 3.81), Hispanic ethnicity (OR = 2.10), chronic sinusitis (OR = 5.59), and visits in the Northeast (OR = 2.12) and Midwest (OR = 2.25) regions had higher odds of documented asthma control status, whereas undocumented asthma severity (OR = 0.02), and visits in spring (OR = 0.34), had lower odds. Osteopathic doctors (OR = 0.18), visits in the Northeast region (OR = 0.23), chronic sinusitis (OR = 0.08), and undocumented asthma control status (OR = 0.03) had lower odds of documented asthma severity, whereas visits in spring (OR = 3.88) and autumn (OR = 3.32) had higher odds. Moderate/severe persistent asthma (OR = 15.35) had higher odds of uncontrolled asthma (as compared to intermittent asthma), while visits in the summer (OR = 0.14) had lower odds. Conclusion: The findings of this study suggest a critical need to increase the documentation of asthma severity and control to improve quality of asthma care in children.

Original languageEnglish (US)
Pages (from-to)205-216
Number of pages12
JournalJournal of Asthma
Volume57
Issue number2
DOIs
StatePublished - Feb 1 2020
Externally publishedYes

Keywords

  • Asthma
  • asthma control
  • asthma severity
  • documentation
  • pediatric
  • uncontrolled asthma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

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