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Importance of hospital care bundle during asthma exacerbations in adults

Published: July 12, 2021

Hospitalization for asthma exacerbation is an important opportunity for initiating preventive care for high-risk patients. However, little is known about the effect of implementing an evidence-based preventive care bundle during hospitalization on the subsequent risk of asthma exacerbation.

In The Journal of Allergy and Clinical Immunology: In Practice, Nanishi and colleagues evaluated the effect of a hospital-initiated asthma care bundle on post-hospitalization asthma care and clinical outcomes. In this study, they implemented an asthma-care bundle (inpatient laboratory testing, asthma education, and discharge care) during hospitalization, and prospectively measured chronic asthma care (e.g., IgE testing, specialist care) and asthma exacerbation (i.e., systemic corticosteroid use, emergency department visit, hospitalizations) outcomes. They examined changes in these outcomes before and after the bundle implementation.

Compared to the pre-implementation period, patients had improved post-hospitalized asthma care, including serum specific IgE testing and evaluation by an asthma specialist, in the post-implementation period. Likewise, after the care bundle implementation, patients had significantly lower rates of systemic corticosteroid use, emergency department visits, and hospitalizations. In this study, the implementation of a hospital-initiated care bundle not only improved the quality of post-hospitalization asthma care but also reduced the rate of severe asthma exacerbation up to 30%. The present study suggested the importance of implementing evidence-based preventive asthma care in patients hospitalized with asthma exacerbation.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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