While it may be a stereotype, it's also true that women seek medical care more frequently than men do. And a recent study shows that women with acute asthma who are treated in the emergency department (ED) are 60 percent more likely than men treated in the ED to need hospitalization.
The study, published in the Annals of Allergy, Asthma and Immunology, the scientific publication of the American College of Allergy, Asthma and Immunology (ACAAI), looked at the sex differences in patient characteristics, and risk of hospitalizations in 2,000 ED patients with acute asthma.
"It's important to note the men and women whose charts we studied had certain things in common," said lead study author Rose Chasm, MD. "Most had not been seen by an allergist, and had not used controller medications (inhaled corticosteroids) for their asthma. In addition, many were overweight and some were active smokers. A fairly high percentage did not have health insurance, although women had it more often than men. After adjusting for all those factors, we found that women were still 60 percent more likely to be hospitalized after being seen in an ED for acute asthma than men."
The authors speculate that there are a number of reasons for their findings, including altered perception of airflow obstruction, potential influences of female sex hormones, differences in bronchial hyper responsiveness and health behaviors. More studies need to be conducted to determine exact reasons.
The study showed that chronic asthma was at play for many of these patients. Thirteen percent of the women and 12 percent of the men had at some point been intubated (had a plastic tube placed into the windpipe to maintain an open airway) for asthma, and 36 percent of the women and 32 percent of the men had ever been hospitalized for asthma. In addition, 16 percent of the women and 13 percent of the men had been hospitalized for asthma in the past 12 months, indicating this was a high risk population with poorly controlled asthma.
"It's long been known that after puberty, asthma is more common in women than men" said allergist James Sublett, MD, ACAAI president. "Only 10 percent of the women in this study had been seen by an allergist in the last year. Many people aren't aware that allergists are asthma specialists, and are among the best-equipped experts to help keep asthma under control. Those who see an allergist and use controller medications find themselves in the ED much less often, and experience fewer hospitalizations related to their asthma."
According to the newly updated ACAAI Asthma Management and the Allergist: Better Outcomes at Lower Cost, asthma care provided by allergists is associated with better patient outcomes across a range of relevant indicators compared to care provided by generalists, including fewer hospitalizations and emergency room visits, higher ratings for the quality of care, fewer restrictions in activities and improved physical functioning. The ACAAI Scope and Impact of the Asthma Epidemic infographic contains valuable asthma management information.
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