Children visited emergency departments (EDs) for asthma more often when they also had depression and/or anxiety, according to a new study.
Researchers said being proactive about managing each of these conditions may help reduce asthma-related ED visit rates.
They analyzed 2014-’15 data from the Massachusetts All-Payer Claims Database on 65,342 children and young adults ages 6-21 years with asthma. About 25% also had depression, anxiety or both, according to “Depression, Anxiety, and Emergency Department Use for Asthma,” (Bardach NS, et al. Pediatrics. Sept. 25, 2019, https://doi.org/10.1542/peds.2019-0856).
There were about 6,385 asthma-related ED visits during the study period, and both unadjusted and adjusted rates were highest among those who also had depression and/or anxiety.
Adjusted asthma-related ED visit rates per 100 child-years were
- 15.5 visits for those with asthma alone;
- 18.9 visits for those with asthma and anxiety;
- 21.7 visits for those with asthma and depression; and
- 27.6 visits for those with asthma, anxiety and depression.
“The cognitive load of managing multiple conditions can degrade the capacity to successfully manage one or both,” authors wrote.
They said patients also may present to the ED with symptoms like shortness of breath or rapid heartbeat that could be linked to either the asthma or their mental health condition. Being proactive may help lower ED use.
“Strategies may include more intensive counseling to improve chronic medication adherence and symptom recognition for asthma, close outpatient follow-up for chronic issues, and improved mental health care for these children, in whom untreated depression or anxiety may hinder asthma self-management,” authors wrote.
