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The importance of specific education for asthma patients discharged from the emergency department and hospital.

Discharge education from the hospital or emergency department (ED) is a challenging affair for everyone, including the asthma patient. An article in this issue of the Journal 1 identifies a lack of documentation of asthma education for patients discharged from the hospital. This properly suggests the likelihood of problems with education for those patients lacking such documentation. This problem also exists in the ED. While there may be more time or opportunity to conduct education for the patient admitted to the hospital, challenges in discharge from either the hospital or ED remain. We will address issues of discharge education from both settings. Concerning the finding of lack of documentation, as the authors note, education may occur in the course of the encounter that is not formally documented. 2 More importantly, even where the authors find documentation, there is not a description of the content of the materials distributed or documented. There are two crucial questions. First, where in the course of the encounter is education best done? And second, what is the content of that education? A recent article accompanying “pro and con” editorials describes a successful ED education program for patients. 3–5 A limitation in this program was the format. Education was done in a dedicated 20-minute session by one of the investigators, an experienced asthma clinician and educator. This format is unlikely to be practical in many hospitals and most EDs in the United States at this time. Most hospitals and EDs do not have independent, dedicated personnel for this task. Education thus is best done by the staff caring for the patient during the course of the hospital admission or ED encounter, which can include the nursing, medical, and respiratory staff. For example, during the course of the history, it may be discovered that a patient who should have been prescribed inhaled corticosteroids has not; this problem can be identified to the patient at that time and again when discharge medication plans are made. The recent US asthma guidelines 6 suggest the content for