Indicators of Non-adherence to Asthma Treatment in Pediatric Primary Care

Purpose: Chronic disease management represents an ongoing challenge, as many childhood illnesses require complex medical management by primary care providers. Asthma is one such illness, and today there is evidence to support primary care-based management strategies that will benefit patients with asthma throughout a lifetime. This study seeks to find significant indicators of asthma non-adherence in pediatric primary care, with potential for utilization in the medical home model. Design and Methods: Potential indicators included in a chart review process of one large Southeastern U.S. primary care pediatric practice were reviewed from the previous calendar year for asthma patients. The study retroactively looks at the incidence of six indicators in relation to asthma-related emergency department visits and hospitalizations, and number of missed appointments for clinically relevant associations. Results: Strong associations were found between emergency department visits and hospitalizations and many of the indicators of non-adherence with high statistical significance. No associations were found between number of missed appointments and the selected indicators. Conclusions: The data analysis performed from the collected patient information can be helpful to guide practices in further discussions on the topic. Results were analyzed and reported to the practice in review as recommendations for a new medical home asthma documentation protocol that is in development. (C) 2017 Elsevier Inc. All rights reserved.