Pediatric asthma: anxiety, depression linked to greater ED use

  • Bardach NS & al.
  • Pediatrics
  • 25/09/2019

  • Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • Children with asthma who have anxiety, depression, or both are more likely than their counterparts without psychiatric diagnoses to use the emergency department (ED).

Why this matters

  • Anxiety and depression have already been linked to increased health care use in adults.
  • Asthma as well as psychiatric conditions can impose heavy cognitive burdens, eroding management and adherence.

Key results

  • ED visits per 100 child-years (95% CIs):
    • Overall: 17.1 (16.7-17.5);
    • Patients with anxiety: 18.6 (16.6-20.6);
    • With depression: 24.8 (20.7-28.8);
    • With both: 30.5 (27.5-33.5); and
    • With neither: 15.2 (14.1-16.3).
  • All unadjusted comparisons, P<.001.>
  • Similar results after adjustment for age, sex, insurance status, chronic illness.

Study design

  • Retrospective cohort study of children and young adults aged 6-21 years in a Massachusetts statewide claims database comprising both public and private payers (n=65,342).
  • Outcome: rate of asthma-related ED visits.
  • Funding: Agency for Healthcare Research and Quality.

Limitations

  • Coded data.
  • May not generalize to other states.
  • No data on race, ethnicity.