Factors associated with frequent emergency room attendance by asthma patients in Palestine

SETTING: The emergency room (ER) of Alia Governmental Hospital in Hebron city, in the southern part of the West Bank.

OBJECTIVE: To investigate the role of asthma severity, health services utilisation and medication use in frequent ER attendance for asthmatics in Palestine.

DESIGN: A cross-sectional study using a previously developed questionnaire.

RESULTS: Of 121 asthma patients, 73.5% were frequent ER attendees during the previous year, with a mean 6.7 visits (standard error 0.75). Moderate/severe asthma and hospital admissions in the previous year due to asthma were the strongest predictors for frequent attendees (adjusted OR [aOR] 6.92, 95%CI 2.44–19.62 and 11.16, 95%CI 4.37–28, respectively). Frequent attendees reported more difficulties in using asthma inhalers compared to one-time ER attendees (aOR 2.49, 95%CI 1.04–5.99). Inhaled short-acting ₂-agonists were reported to be used regularly, on most days, by frequent attendees (≥1 canister/month) compared to one-time attendees (aOR 4.4, 95%CI 1.28–15 and 4.05, 95%CI 1.33–12, respectively).

CONCLUSIONS: Lack of proper use of inhalers and an over-reliance on reliever therapy contributes to asthma morbidity in Palestine. We recommend an intervention programme at the professional and patient levels.