Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis
Background: There are limited data comparing the effectiveness of multidisciplinary severe asthma clinics (SACs) with that of conventional single-discipline clinics (SDCs) for pediatric severe asthma. Objective: Our aim was to compare asthma outcomes between SACs and SDCs clinics and examine longitu...
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Elsevier
2025-05-01
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| Series: | Journal of Allergy and Clinical Immunology: Global |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772829325000189 |
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| author | Adam S. Price, MD Akilah A. Jefferson-Shah, MD Robert D. Pesek, MD Erhan Ararat, MD Safia F. Nawaz, MD Matthew Pertzborn, MD Kim Cobb, RT Haley Long, RT Monica Y. Miller, LMSW Brandi N. Whitaker, PhD Stacie M. Jones, MD Scott Stewart, MS Daniel Liu, MD Tamara T. Perry, MD |
| author_facet | Adam S. Price, MD Akilah A. Jefferson-Shah, MD Robert D. Pesek, MD Erhan Ararat, MD Safia F. Nawaz, MD Matthew Pertzborn, MD Kim Cobb, RT Haley Long, RT Monica Y. Miller, LMSW Brandi N. Whitaker, PhD Stacie M. Jones, MD Scott Stewart, MS Daniel Liu, MD Tamara T. Perry, MD |
| author_sort | Adam S. Price, MD |
| collection | DOAJ |
| description | Background: There are limited data comparing the effectiveness of multidisciplinary severe asthma clinics (SACs) with that of conventional single-discipline clinics (SDCs) for pediatric severe asthma. Objective: Our aim was to compare asthma outcomes between SACs and SDCs clinics and examine longitudinal health outcomes for patients with severe asthma who were followed in SACs. Methods: We conducted a retrospective cohort study comparing pediatric asthma outcomes among patients with severe asthma between 2018 and 2022 who were treated at the multidisciplinary Arkansas Children's SAC with those of patients with severe asthma treated at SDCs. The primary outcome was acute health care utilization, including hospitalizations and emergency department visits. Secondary outcomes included systemic corticosteroid prescriptions and controller medications. For SAC enrollees, longitudinal outcomes including health care utilization, symptom control, and spirometry were evaluated 12 months before and after enrollment. Data sources included the electronic health record and SAC patient registry. Results: The study population included 280 patients with severe asthma, aged 5 to 18 years, from the SAC (n = 56) and SDCs (n = 224). The SAC patients were more likely to be Black (79% vs 52% [P = .0002]), be non-Hispanic (100% vs 88% [P = .01]), have had at least 1 hospitalization (21% vs 10% [P = .04]), and have received at least 2 prescriptions for a systemic corticosteroid (34% vs 17% [P = .01]). Longitudinal outcomes among patients for the 12 months before SAC enrollment versus 12 months after SAC enrollment demonstrated significant reductions in acute exacerbations (from 35 to 8 [P < .001]), hospitalizations (from 21 to 1 [P < .001]), and intensive care unit admissions (from 8 to 1 [P = .02]). Conclusions: The study highlights significant morbidity among predominately Black pediatric patients with severe asthma, particularly those followed in a SAC versus in SDCs at a tertiary care referral center. The findings demonstrate the value of targeted multidisciplinary approaches to reduce asthma utilization and improve outcomes among high-risk patients. |
| format | Article |
| id | doaj-art-e021db70b7bb4e8084c06159269ae3fe |
| institution | Kabale University |
| issn | 2772-8293 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj-art-e021db70b7bb4e8084c06159269ae3fe2025-02-08T05:01:44ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-0142100417Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysisAdam S. Price, MD0Akilah A. Jefferson-Shah, MD1Robert D. Pesek, MD2Erhan Ararat, MD3Safia F. Nawaz, MD4Matthew Pertzborn, MD5Kim Cobb, RT6Haley Long, RT7Monica Y. Miller, LMSW8Brandi N. Whitaker, PhD9Stacie M. Jones, MD10Scott Stewart, MS11Daniel Liu, MD12Tamara T. Perry, MD13Allergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children’s Research Institute, Little Rock, Ark; Corresponding author: Adam S. Price, MD, 13 Children’s Way, Slot 512-13, Little Rock, AR 72202.Allergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children’s Research Institute, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children’s Research Institute, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Pulmonology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children’s Research Institute, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Pulmonology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Pulmonology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Pulmonology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, ArkSocial Work Division, Arkansas Children’s Hospital, Little Rock, ArkPediatric Psychology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children’s Research Institute, Little Rock, ArkBiostatistics Division, the University of Arkansas for Medical Sciences, Little Rock, ArkBiomedical Informatics Division, the University of Arkansas for Medical Sciences, Little Rock, ArkAllergy Immunology Division, the Department of Pediatrics, the University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children’s Research Institute, Little Rock, ArkBackground: There are limited data comparing the effectiveness of multidisciplinary severe asthma clinics (SACs) with that of conventional single-discipline clinics (SDCs) for pediatric severe asthma. Objective: Our aim was to compare asthma outcomes between SACs and SDCs clinics and examine longitudinal health outcomes for patients with severe asthma who were followed in SACs. Methods: We conducted a retrospective cohort study comparing pediatric asthma outcomes among patients with severe asthma between 2018 and 2022 who were treated at the multidisciplinary Arkansas Children's SAC with those of patients with severe asthma treated at SDCs. The primary outcome was acute health care utilization, including hospitalizations and emergency department visits. Secondary outcomes included systemic corticosteroid prescriptions and controller medications. For SAC enrollees, longitudinal outcomes including health care utilization, symptom control, and spirometry were evaluated 12 months before and after enrollment. Data sources included the electronic health record and SAC patient registry. Results: The study population included 280 patients with severe asthma, aged 5 to 18 years, from the SAC (n = 56) and SDCs (n = 224). The SAC patients were more likely to be Black (79% vs 52% [P = .0002]), be non-Hispanic (100% vs 88% [P = .01]), have had at least 1 hospitalization (21% vs 10% [P = .04]), and have received at least 2 prescriptions for a systemic corticosteroid (34% vs 17% [P = .01]). Longitudinal outcomes among patients for the 12 months before SAC enrollment versus 12 months after SAC enrollment demonstrated significant reductions in acute exacerbations (from 35 to 8 [P < .001]), hospitalizations (from 21 to 1 [P < .001]), and intensive care unit admissions (from 8 to 1 [P = .02]). Conclusions: The study highlights significant morbidity among predominately Black pediatric patients with severe asthma, particularly those followed in a SAC versus in SDCs at a tertiary care referral center. The findings demonstrate the value of targeted multidisciplinary approaches to reduce asthma utilization and improve outcomes among high-risk patients.http://www.sciencedirect.com/science/article/pii/S2772829325000189Severe asthmapediatricsmultidisciplinary clinicasthma outcomeselectronic health recordacute health care utilization |
| spellingShingle | Adam S. Price, MD Akilah A. Jefferson-Shah, MD Robert D. Pesek, MD Erhan Ararat, MD Safia F. Nawaz, MD Matthew Pertzborn, MD Kim Cobb, RT Haley Long, RT Monica Y. Miller, LMSW Brandi N. Whitaker, PhD Stacie M. Jones, MD Scott Stewart, MS Daniel Liu, MD Tamara T. Perry, MD Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis Journal of Allergy and Clinical Immunology: Global Severe asthma pediatrics multidisciplinary clinic asthma outcomes electronic health record acute health care utilization |
| title | Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis |
| title_full | Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis |
| title_fullStr | Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis |
| title_full_unstemmed | Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis |
| title_short | Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis |
| title_sort | multidisciplinary care in pediatric severe asthma a comparative outcomes analysis |
| topic | Severe asthma pediatrics multidisciplinary clinic asthma outcomes electronic health record acute health care utilization |
| url | http://www.sciencedirect.com/science/article/pii/S2772829325000189 |
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