Asthma severity and management

Patients between the ages of 18 and 55 years, who presented to the ED between 8:00 am and midnight 7 days a week and who were assessed to be having an acute asthma exacerbation, were eligible to be included in the study. Patients with other diagnoses such as COPD and congestive heart failure were excluded.

This was a prospective study during which patients were interviewed to determine the extent of cocaine and opiate use as well as treatment modalities being administered. Approval from the hospital’s institutional review board was obtained. Informed consent was obtained from patients entering the study, which involved completing a facilitated questionnaire and providing a urine sample for drug screening (cocaine and opiates). One hundred sixteen patients were interviewed. Complete data, including urine screens, were available for 103 subjects. A research facilitator conducted the interview (Fig 1). Questions assessed prior asthma severity and management (including use of ICS and P2-agonists), as well as history of tobacco, alcohol, and illicit viagra canada drugs use. Information regarding the patient’s current presentation, ED treatment, and disposition were documented on a data collection form by the facilitator. Patients who were too ill on initial presentation to consent to the study were approached later once their condition stabilized.

Urine samples were analyzed for the presence of the cocaine metabolite benzoylecgonine, as well as for opiates, using the Axsym system (Abbott Laboratories; Abbott Park, IL). (A cutoff value of > 300 ng/mL is considered to be a positive result for a cocaine metabolite assay by our hospital laboratory, as recommended by the National Institute on Drug Abuse.)

The prevalence of positive cocaine screens was assessed; all clinical data were entered into a database and were analyzed using computer software (SPSS for Windows, version 7.5; SPSS; Chicago, IL).


Patients were enrolled during a 7-month period (January 14, 1998, through August 25, 1998). One hundred sixty-three patients were approached to enter the study: of these, 116 patients consented to the study, completing the questionnaire and giving urine samples.

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