Impact of Emergency Department Preventative Strategies on Acute Asthma Revisits

Despite the available evidence-based guidelines for asthma management, asthma prevalence is increasing, and exacerbations continue to be a major cause of emergency department (ED) visits (1). Therefore, we aimed to determine which emergency department preventative strategies (EDPS) are being implemented in Regina EDs and if these strategies effectively prevent asthma-related ED revisits. We hypothesized that the current EDPS used in Regina are not sufficient for preventing asthma revisits. We conducted a retrospective chart review of all patients aged 1-17 years inclusive that have presented to Regina area EDs for an acute asthma exacerbation from September 1, 2023 – August 31st, 2024. EDPS included the provision of a prescription for the inhaled corticosteroid, an asthma action plan (AAP), and/or referral to a pediatrician or pediatric respirologist. 315 patients were identified, and 237 patients met the inclusion criteria. Inhaled corticosteroid prescription was the preferred EDPS for preventing asthma exacerbation-related revisits to the ED. However, 24% of patients returned to the ED for an acute asthma exacerbation during the study period, and none of the EDPS demonstrated an impact on decreasing revisits. Further studies are needed to better characterize the EDPS and the context of their use, and outpatient asthma education programs for post-ED visits should be considered.