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Well-child visits associated with lower risk of asthma exacerbations

January 1, 2021

Children with asthma who had a well-child visit within the past year were at lower risk of having an exacerbation or hospitalization for asthma, according to a retrospective study of 5,656 children.

Estimates from the Centers for Disease Control and Prevention show there were about 76,000 asthma-related hospital inpatient stays and 627,000 emergency department visits in 2017 by children under 18.

While well-child care (WCC) is intended to promote child health, few studies have looked at how WCC affects asthma outcomes.

Researchers used a large health system’s electronic health records to determine if lack of WCC was associated with health care visits for disease flare-up.

They identified all patients ages 5-17 years who were diagnosed with asthma and received care from 2014 through 2019. They looked at whether the patients had one or more WCC visits each year and how often asthma-related preventive care was given during those visits. Then, they determined if patients had a health care visit for asthma that included a prescription for a systemic glucocorticoid and categorized those visits by severity.

Results showed most WCC visits included asthma care such as a prescription for asthma medication, administration of flu vaccine and assessment of a co-morbidity that can affect disease control.

There were 2,974 asthma exacerbations during the study period. A WCC visit in the past year was associated with a 10% reduction in any exacerbation and a 47% reduction in hospitalization.

“Our data reveal that children without a WCC in the past 12 months are at significantly increased risk for severe exacerbations and would benefit from health system contact,” the authors wrote. “Secondly, pediatricians should conclude that disease specific targeted management is worth the time investment during busy WCC visits.”

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