Evaluation of Real-World Quality of Asthma Care According to the Spanish Consensus Protocol: The AsmaNET Project (ESR-20-20897).

Abstract

Background: The emergency room (ER) approach for patients with asthma exacerbations (AEs) should be based on a comprehensive, multidisciplinary approach to ensure effective and timely care. This study aims to analyze the compliance level of recommended indicators, as defined in a consensus document, for the management of AEs in the ER using available electronic medical records.

Methods: An open-label, observational, non-interventional, retrospective study of adult patients treated in hospital ER for AEs was conducted at La Paz University Hospital and Salamanca University Hospital. Data were collected from medical records regarding a set of predefined measures and variables concerning asthma severity, ER stay, and subsequent discharge.

Results: During 2019, a total of 1,019 patients accounted for 1,089 AEs were evaluated. Clinical variables predominantly included historical data, such as previous hospitalizations, Intensive Care Unit admissions, and prior exacerbations, which were recorded in 45.8% of medical records. Auscultation details were extensively documented (99.8%), yet respiratory rate (25.4%) and spirometry (less than 10%) were notably lower. Regarding discharge planning, 69.6% of patients had a defined care plan, and 59.5% received Inhaled Corticosteroids plus Long-Acting Beta-Agonists combination treatment at discharge. Medical referrals resulted in 25.5% being referred for specialized care and 87.2% to primary care. 13.3% had a specific post-discharge care timeframe.

Conclusion: This study highlights significant variability in the documentation and adherence to recommended indicators for AE management in the ER. Moreover, discharge planning and follow-up care were suboptimal. These findings underscore the need for improved standardization and implementation of evidence-based protocols in emergency asthma care.