Evidence map›Paper›PMID 37041095›Full record

ArticleThe Journal of emergency medicine2023

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care.

Sophie Karwoska Kligler, Carmen Vargas-Torres, Ethan E Abbott, Michelle P Lin

Open access · greenAbstract read
In one paragraph

Article in The Journal of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Sophie Karwoska KliglerDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Carmen Vargas-TorresDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Ethan E AbbottDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Michelle P LinDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York; Icahn School of Medicine at Mount Sinai, Institute for Health Equity Research, New York, New York.
Icahn School of Medicine at Mount Sinai · US

Funding

Conduits: Mount Sinai Health System Translational Science HubUL1TR004419 · NCATS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Rosalind J Wright · 2022 to 2026
$46.4M
Mount Sinai Clinician Scientist Training Program in Emergency Care ResearchT32HL129974 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI RICHARDSON, LYNNE D. · 2016 to 2020
$2.3M
Mount Sinai Clinician Scientist Training Program in Emergency Care ResearchT32HL160513 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Lynne D. Richardson · 2022 to 2026
$2.2M
PROAACT- Admin SupplementK23HL143042 · NHLBI · STANFORD UNIVERSITY · PI LIN, MICHELLE P · 2019 to 2023
$1.0M
NCATS NIH HHS UL1 TR004419NHLBI NIH HHS K23 HL143042NHLBI NIH HHS T32 HL129974NHLBI NIH HHS T32 HL160513
6 · The paper itself

Abstract

backgroundGuidelines recommend an inhaled corticosteroid (ICS) prescription on emergency department (ED) discharge after acute asthma exacerbations.

objectiveWe sought to identify rates and predictors of ICS prescription at ED discharge. Secondary outcomes included ICS prescription rates in a high-risk subgroup, outpatient follow-up rates within 30 days, and variation in ICS prescriptions among attending emergency physicians.

methodsThis was a retrospective cohort study of adult asthma ED discharges for acute asthma exacerbation across 5 urban academic hospitals. We used multivariable logistic regression to evaluate predictors of ICS prescription after adjusting for patient characteristics and hospital-level clustering.

resultsAmong 3948 adult ED visits, an ICS was prescribed in 6% (n = 238) of visits. Only 14% (n = 552) completed an outpatient visit within 30 days. Among patients with 2 or more ED visits in 12 months, the ICS prescription rate was 6.7%. ICS administration in the ED (odds ratio [OR] 9.91; 95% CI 7.99-12.28) and prescribing a β-agonist on discharge (OR 2.67; 95% CI 2.08-3.44) were associated with higher odds of ICS prescription. Decreased odds of ICS prescription were associated with Hispanic ethnicity (OR 0.71; 95% CI 0.51-0.99) relative to Black race, and private (OR 0.75; 95% CI 0.62-0.91) or no insurance (OR 0.54; 95% CI 0.35-0.84) relative to Medicaid. One-third (36%, n = 66) of ED attendings prescribed 0 ICS prescriptions during the study period.

conclusionsAn ICS is infrequently prescribed on ED asthma discharge, and most patients do not have an outpatient follow-up within 30 days. Future studies should examine the extent to which ED ICS prescriptions improve outcomes for patients with barriers to accessing primary care.

Indexed as

AsthmaPatient DischargeAdministration, InhalationAdrenal Cortex HormonesAdultAftercareEmergency Service, HospitalHospitals, UrbanHumansRetrospective StudiesAdrenal Cortex Hormonesasthmaemergency departmentinhaled corticosteroidprescription

Identifiers

PMID37041095
PMCPMC10192099
OpenAlexW4328100130

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.