Caregiver Knowledge Predicts Asthma Patients’ Length of Stay

According to new research presented at the ACAAI annual meeting, children of caregivers with poor asthma knowledge are four times more likely to have a prolonged hospital stay, defined as longer than two days.

Asthma exacerbations are a leading cause of hospitalizations and missed school days for children. This study, which won the Clemens von Pirquet Award, enrolled the caregivers of 73 children aged 2 to 17 who were hospitalized with asthma exacerbations between December 2012 and December 2013. The caregivers completed questionnaires at admission, upon discharge, and 4 to 6 weeks after discharge.

“If the caregiver had poor asthma knowledge when their child was admitted, the odds were four times greater that the child’s length of hospital stay would be longer than two days,” said lead author and allergist Deepti Deshpande, MD, MPH. “If caregiver asthma knowledge was good, the odds were strong that the child’s hospital stay would be less than two days.”

The results were adjusted for age, baseline asthma control, stay in the pediatric intensive care unit, parental education level, payer, and ethnicity. All caregivers received education during the inpatient stay, including interactive materials and demonstration of correct inhaler technique. They were taught about asthma triggers, how to avoid them, and how to use an asthma action plan. After education, the caregivers demonstrated increased knowledge, particularly about asthma action plans.

“We focused on providing families with a better understanding of medications, their use, side effects, and correct technique for use of devices to help improve use,” Deshpande said.

Additionally, at 4 to 6 weeks after discharge, 90 percent of caregivers were able to correctly name their children’s rescue medicines, and 73 percent were correctly able to name their controller medicines. The researchers called for prospective research to examine whether improving caregiver knowledge can shorten hospital stays and healthcare utilization in general.