Why Patients With Asthma Go to the Emergency Room-Reply

Lois A. Maiman, PhD; Lawrence W. Green, DPH; Geoffry Gibson, PhD
JAMA. 1980;243(8):732. doi:10.1001/jama.1980.03300340012006.
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In Reply.—  We have read Dr Aelony's reaction to our article. He suggests possible alternative treatment in the emergency room for asthma attacks: the use of oral medications similar to the ones the patient can use at home. The author states that an efficacious experience with oral agents in the emergency room situation will replace the need for educational interventions for subsequent self-management of asthma.We agree the use of oral agents in the emergency room would provide a demonstrated and reinforcing experience for future self-treatment with such medications. However, Dr Aelony is in error in assuming continuous compliance will result if a patient has one effective experience with the treatment recommended for selfadministration.If Dr Aelony's assumptions were true, how can the low rates of cooperation or compliance with prescribed medical regimens be explained where persons have experienced the benefits of the regimen? Certainly there are many therapeutic situations


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