By Dr. Larry Chiaramonte
The new study by doctors at Cornell-Weill mentioned on our Journals page should surprise no one. We beat the drum about controlling asthma being the best defense against trips to the emergency room. It is logical that patients whose asthma isn’t managed at home should also be the most dilatory about seeking treatment after an exacerbation begins, and therefore require hospitalization. This is where the ounce-of-prevention-worth-a-pound-of-cure principle comes into play–again. A month’s supply of medication costs your insurance company—if you have one–at most a couple of hundred bucks; and ER visit costs almost a thousand, more or less; a hospital stay costs thousands per day.
With asthma, the earlier the treatment the better. But better still is prevention. Early in my career, I endorsed home monitoring using a peak flow meter—a low-tech, low-cost instrument that is as good as it ever was for the average patient. I wanted patients to be empowered to take responsibility for their own health, which didn’t make me very popular with my colleagues, and they launched a media campaign against me. Now home monitoring is part of the government guidelines. Unfortunately, there still isn’t enough of it.