Abstract
IntroductionWhile only 10% of asthmatics have “Difficult Asthma” they account for 80% of asthma-related expenditure. The presence of psychiatric co-morbidity is reported as being present in 25-29%. We assessed the impact of input from a Psychologist on a cohort of frequently-admitted asthmatics at Southampton General Hospital. Our aim was to assess whether this intervention decreased the extent to which they required hospitalisation for asthma.
MethodsHaving previously identified a cohort of asthmatics with psychological co-morbidity who had been admitted to Southampton Hospital with an asthma exacerbation two or more times in the previous 12 months, we offered those patients an appointment with our clinical psychologist. Data was retrospectively collected and covered patient demographics, admission details and psychological co-morbidity.
ResultsWe compared admissions and bed-days for asthma admissions in the six-month period before and after initial contact with our psychologist. We included 11 patients who completed a course of therapy. This group were predominantly female (84%) with an average BMI of 34.1. They had high levels of psychological co-morbidity (69.2%), vocal cord dysfunction (53.9%) and dysfunctional breathing (76.9%).
Prior to intervention the group had 19 asthma admissions and utilised 198 bed days; in the same time period after intervention the group had 10 admissions to hospital and utilised 97 bed days. This is a reduction of 101 bed days (51.0%) over 6 months.
ConclusionPsychological co-morbidity is common in difficult-to-control asthma and addressing this co-morbidity decreases hospital bed-days for asthma exacerbations in this frequently healthcare-utilising population.
- © 2014 ERS