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Emerg Med J 2009;26:187-192 doi:10.1136/emj.2008.059188
  • Original Article

The health behaviour and clinical characteristics of ambulance users with acute asthma

  1. S M S Smith1,5,
  2. C Mitchell2,3,
  3. S D Bowler4,
  4. C Heneghan1,
  5. R Perera1
  1. 1
    Centre for Evidence-Based Medicine, Department of Primary Health Care, University of Oxford, Oxford, UK
  2. 2
    School of Medicine, University of Queensland, Herston, Australia
  3. 3
    Princess Alexandra Hospital, Woolloongabba, Australia
  4. 4
    Department of Medicine, Mater Adult Public Hospital, South Brisbane, Australia
  5. 5
    Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, UK
  1. Dr S Smith, Imperial College Healthcare NHS Trust, Chest and Allergy, 1st Floor Mint Wing, St Mary’s Hospital, London W2 1NY, UK; sheree.smith{at}imperial.nhs.uk
  • Accepted 24 August 2008

Abstract

Objective: This study sought to determine if ambulance service users differ in their health behaviours to “walk-in” patients attending an emergency department (ED) with acute asthma.

Method: Retrospective cross-sectional study of people with acute asthma stratified by ambulance use attending two ED. The health-promoting lifestyle profile and health risk appraisal tools assessed health and risk-taking behaviours, and the clinical variables assessed include: forced expiratory volume in 1 s, admission rates, severity, asthma medications, anxiety and depression.

Results: Of the 142 patients, 26% used the ambulance service as transport to the ED. Ambulance users were significantly older than walk-in patients (40 vs 32 years, p≤0.05) and were less likely to return to follow-up appointments (odds ratio (OR) 2.93, 95% CI 1.16 to 7.37). Walk-in patients were more likely to report higher levels of education (OR 4.36, 95% CI 1.11 to 17.09). There was no difference between the groups for health-promoting behaviours. In reducing risks to their health and after adjusting for age and gender, there was a trend towards ambulance users undertaking preventive health measures more often than walk-in patients.

Conclusions: Ambulance users with acute asthma are more likely to be older, married and less educated. There is no evidence that this group is less responsible in managing their health; however, fewer ambulance users attended their follow-up appointment and the implication for ongoing care requires further investigation.

Footnotes

  • Funding: This study was supported by CRC for Asthma and Asthma Australia, Health Education and Health Promotion Scholarship 2001 and Asthma Foundation of Queensland grant no 2001/2.

  • Competing interests: Declared. SDB reports having received speaker’s fees from Astra Zeneca, Glaxo-Smith-Kline and Altana. The other authors report no conflicts of interest.

  • Ethics approval: Ethical clearance was obtained from both participating hospitals and Queensland University of Technology’s Ethics Committee.

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