Persistent nighttime asthma symptoms were associated with poorer functional health outcomes among teens, independent of daytime symptoms, according to a cross-sectional study published in the Journal of Asthma. Researchers found that identifying nighttime symptoms and improving asthma control at night may positively impact daily functioning for these teens. To identify associations between nocturnal asthma awakenings and functional health outcomes in a cohort of teenagers with asthma, they analyzed baseline data from teenagers enrolled in a National Institutes of Health-funded randomized controlled trial. During an at-home baseline survey, teenagers with asthma answered questions about demographics, recent asthma symptoms, and functional health outcomes. The study team conducted regression analyses to explore the relationship between persistent nocturnal asthma symptoms (≥2 nights of nocturnal asthma awakenings in the past 14 days) and functional health outcomes. Of the teens enrolled, more than half were male, Black, and insured by Medicaid, and 30% reported persistent nocturnal asthma symptoms. Compared with teens with intermittent nocturnal asthma symptoms, teens with persistent nocturnal asthma symptoms were more likely to report feeling limited during strenuous activities, moderate activities, and school gym class. They were also more likely to report depressive symptoms, more asthma-related school absences in the past 14 days, and poorer quality of life. These findings remained significant when controlling for daytime asthma symptoms, weight status, race, ethnicity, gender, age, and smoke exposure.
Nurse Practitioner Consultations Boost Patient Follow-Up Appointments
Patients with asthma who saw a pulmonology nurse practitioner (NP) were more likely to have controllers started or adjusted per guidelines and were more likely to attend specialty follow-up appointments following discharge from a pediatric intensive care unit (PICU), according to a study published in the Journal of Asthma. However, no impact was seen on emergency department (ED) visits or readmissions. Implementation of such a program may aid in optimizing asthma management and continuity of care following hospitalization, the study investigators said. They sought to determine the effects of a multi-dimensional intervention (consisting of education, recommendations for medical management, and short-term case management) provided by pulmonology NPs on inpatient and post-discharge outcomes for patients admitted with asthma exacerbations to a PICU. A retrospective cohort study was completed on patients (n = 222) from January 1, 2015 to December 31, 2018. Records were reviewed for 12 months post-discharge. Of all participants, 101 (45.5%) received NP consultation and 121 (54.5%) received PICU management only. Patients with NP consultation were more likely to have controllers initiated (34.6% vs 15.0%) or adjusted (55.5% vs.33.3%) per asthma guidelines. The consult group was more likely to have an asthma follow-up appointment made prior to discharge (99% vs 45%) and were more likely to attend (51% vs 21%). There were no significant differences between groups for ED visits or readmission for asthma 12 months post-discharge.
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