Outcomes of stepping down asthma medications in a guideline-based pediatric asthma management program

Matthew A Rank, Megan E. Branda, Deborah B. McWilliams, Shirley K. Johnson, Shefali A. Samant, Jenna C. Podjasek, Miguel Park, Gerald W. Volcheck

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Little is known about outcomes after stepping down asthma medications within an asthma management program. Objective: To determine outcomes of stepping down asthma medications in a pediatric asthma management program. Methods: We performed a retrospective study of 5- to 18-year-old children with asthma in an integrated primary care practice in the United States. Data were included on participants from March 1, 2009, until December 31, 2011. We first determined whether a child was eligible for step down and next recorded whether a step-down attempt was made and if the attempt was successful. In addition to descriptive statistics for the sample demographics and the outcomes of stepping down, univariate and multivariate analyses were performed to determine predictors of successful asthma medication step-down attempts. Results: Of the 477 children sampled for this study, 264 (55.3%) had a guideline-eligible opportunity to step down asthma medications. An attempted step down occurred in only 89 (33.7%) of children who had guideline-eligible opportunities. A total of 166 children (34.8%) attempted a step down of asthma medication at least once (including those guideline ineligible to step down). Of children with follow-up, 96 (71.6%) of step-down attempts were successful. Time of year (any season except fall) when the step down was attempted predicted successful step down in univariate and multivariate analysis (odds ratio = 3.81; 95% confidence interval, 1.23-11.85; P =.02). Being guideline eligible for step down predicted successful step down in univariate analysis only (odds ratio = 2.51; 95% confidence interval, 1.16-5.43; P =.02). Conclusion: Our findings from this sample of children participating in an asthma management program suggest that stepping down asthma medication based on National Asthma Education and Prevention Program 3 guidelines is frequently successful.

Original languageEnglish (US)
Pages (from-to)354-358
Number of pages5
JournalAnnals of Allergy, Asthma and Immunology
Volume110
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Asthma
Guidelines
Pediatrics
Multivariate Analysis
Odds Ratio
Confidence Intervals
Primary Health Care
Retrospective Studies
Demography
Education

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Rank, M. A., Branda, M. E., McWilliams, D. B., Johnson, S. K., Samant, S. A., Podjasek, J. C., ... Volcheck, G. W. (2013). Outcomes of stepping down asthma medications in a guideline-based pediatric asthma management program. Annals of Allergy, Asthma and Immunology, 110(5), 354-358. https://doi.org/10.1016/j.anai.2013.02.012

Outcomes of stepping down asthma medications in a guideline-based pediatric asthma management program. / Rank, Matthew A; Branda, Megan E.; McWilliams, Deborah B.; Johnson, Shirley K.; Samant, Shefali A.; Podjasek, Jenna C.; Park, Miguel; Volcheck, Gerald W.

In: Annals of Allergy, Asthma and Immunology, Vol. 110, No. 5, 05.2013, p. 354-358.

Research output: Contribution to journalArticle

Rank, Matthew A ; Branda, Megan E. ; McWilliams, Deborah B. ; Johnson, Shirley K. ; Samant, Shefali A. ; Podjasek, Jenna C. ; Park, Miguel ; Volcheck, Gerald W. / Outcomes of stepping down asthma medications in a guideline-based pediatric asthma management program. In: Annals of Allergy, Asthma and Immunology. 2013 ; Vol. 110, No. 5. pp. 354-358.
@article{7e65307ca730454c970a6d6a03cdbfe1,
title = "Outcomes of stepping down asthma medications in a guideline-based pediatric asthma management program",
abstract = "Background: Little is known about outcomes after stepping down asthma medications within an asthma management program. Objective: To determine outcomes of stepping down asthma medications in a pediatric asthma management program. Methods: We performed a retrospective study of 5- to 18-year-old children with asthma in an integrated primary care practice in the United States. Data were included on participants from March 1, 2009, until December 31, 2011. We first determined whether a child was eligible for step down and next recorded whether a step-down attempt was made and if the attempt was successful. In addition to descriptive statistics for the sample demographics and the outcomes of stepping down, univariate and multivariate analyses were performed to determine predictors of successful asthma medication step-down attempts. Results: Of the 477 children sampled for this study, 264 (55.3{\%}) had a guideline-eligible opportunity to step down asthma medications. An attempted step down occurred in only 89 (33.7{\%}) of children who had guideline-eligible opportunities. A total of 166 children (34.8{\%}) attempted a step down of asthma medication at least once (including those guideline ineligible to step down). Of children with follow-up, 96 (71.6{\%}) of step-down attempts were successful. Time of year (any season except fall) when the step down was attempted predicted successful step down in univariate and multivariate analysis (odds ratio = 3.81; 95{\%} confidence interval, 1.23-11.85; P =.02). Being guideline eligible for step down predicted successful step down in univariate analysis only (odds ratio = 2.51; 95{\%} confidence interval, 1.16-5.43; P =.02). Conclusion: Our findings from this sample of children participating in an asthma management program suggest that stepping down asthma medication based on National Asthma Education and Prevention Program 3 guidelines is frequently successful.",
author = "Rank, {Matthew A} and Branda, {Megan E.} and McWilliams, {Deborah B.} and Johnson, {Shirley K.} and Samant, {Shefali A.} and Podjasek, {Jenna C.} and Miguel Park and Volcheck, {Gerald W.}",
year = "2013",
month = "5",
doi = "10.1016/j.anai.2013.02.012",
language = "English (US)",
volume = "110",
pages = "354--358",
journal = "Annals of Allergy, Asthma and Immunology",
issn = "1081-1206",
publisher = "American College of Allergy, Asthma and Immunology",
number = "5",

}

TY - JOUR

T1 - Outcomes of stepping down asthma medications in a guideline-based pediatric asthma management program

AU - Rank, Matthew A

AU - Branda, Megan E.

AU - McWilliams, Deborah B.

AU - Johnson, Shirley K.

AU - Samant, Shefali A.

AU - Podjasek, Jenna C.

AU - Park, Miguel

AU - Volcheck, Gerald W.

PY - 2013/5

Y1 - 2013/5

N2 - Background: Little is known about outcomes after stepping down asthma medications within an asthma management program. Objective: To determine outcomes of stepping down asthma medications in a pediatric asthma management program. Methods: We performed a retrospective study of 5- to 18-year-old children with asthma in an integrated primary care practice in the United States. Data were included on participants from March 1, 2009, until December 31, 2011. We first determined whether a child was eligible for step down and next recorded whether a step-down attempt was made and if the attempt was successful. In addition to descriptive statistics for the sample demographics and the outcomes of stepping down, univariate and multivariate analyses were performed to determine predictors of successful asthma medication step-down attempts. Results: Of the 477 children sampled for this study, 264 (55.3%) had a guideline-eligible opportunity to step down asthma medications. An attempted step down occurred in only 89 (33.7%) of children who had guideline-eligible opportunities. A total of 166 children (34.8%) attempted a step down of asthma medication at least once (including those guideline ineligible to step down). Of children with follow-up, 96 (71.6%) of step-down attempts were successful. Time of year (any season except fall) when the step down was attempted predicted successful step down in univariate and multivariate analysis (odds ratio = 3.81; 95% confidence interval, 1.23-11.85; P =.02). Being guideline eligible for step down predicted successful step down in univariate analysis only (odds ratio = 2.51; 95% confidence interval, 1.16-5.43; P =.02). Conclusion: Our findings from this sample of children participating in an asthma management program suggest that stepping down asthma medication based on National Asthma Education and Prevention Program 3 guidelines is frequently successful.

AB - Background: Little is known about outcomes after stepping down asthma medications within an asthma management program. Objective: To determine outcomes of stepping down asthma medications in a pediatric asthma management program. Methods: We performed a retrospective study of 5- to 18-year-old children with asthma in an integrated primary care practice in the United States. Data were included on participants from March 1, 2009, until December 31, 2011. We first determined whether a child was eligible for step down and next recorded whether a step-down attempt was made and if the attempt was successful. In addition to descriptive statistics for the sample demographics and the outcomes of stepping down, univariate and multivariate analyses were performed to determine predictors of successful asthma medication step-down attempts. Results: Of the 477 children sampled for this study, 264 (55.3%) had a guideline-eligible opportunity to step down asthma medications. An attempted step down occurred in only 89 (33.7%) of children who had guideline-eligible opportunities. A total of 166 children (34.8%) attempted a step down of asthma medication at least once (including those guideline ineligible to step down). Of children with follow-up, 96 (71.6%) of step-down attempts were successful. Time of year (any season except fall) when the step down was attempted predicted successful step down in univariate and multivariate analysis (odds ratio = 3.81; 95% confidence interval, 1.23-11.85; P =.02). Being guideline eligible for step down predicted successful step down in univariate analysis only (odds ratio = 2.51; 95% confidence interval, 1.16-5.43; P =.02). Conclusion: Our findings from this sample of children participating in an asthma management program suggest that stepping down asthma medication based on National Asthma Education and Prevention Program 3 guidelines is frequently successful.

UR - http://www.scopus.com/inward/record.url?scp=84876667644&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876667644&partnerID=8YFLogxK

U2 - 10.1016/j.anai.2013.02.012

DO - 10.1016/j.anai.2013.02.012

M3 - Article

C2 - 23622006

AN - SCOPUS:84876667644

VL - 110

SP - 354

EP - 358

JO - Annals of Allergy, Asthma and Immunology

JF - Annals of Allergy, Asthma and Immunology

SN - 1081-1206

IS - 5

ER -