OBJECTIVE: To assess the impact of an asthma management program on the dispensing of inhaled corticosteroids, hospitalizations, and emergency department (ED) visits on children, adolescents, and young adults. DESIGN: We used medical record and pharmacy data for the 18 months after initiation of a pilot asthma management program. Two intervention offices were matched with 2 control offices on pediatric volume, number of pediatricians or family practitioners, and specialist availability. SETTING: Primary care offices at Kaiser Permanente Colorado, in Denver and Boulder. PATIENTS: We identified 298 patients, 18 years or younger,who were listed in an asthma registry between February 1 and July 31, 1997, as having moderate or severe asthma. INTERVENTION: The Kaiser Permanente Colorado Asthma Care Management Program is an outpatient-based program that provides comprehensive evaluation, education, and follow-up to patients identified from an asthma registry or referred by providers. MAIN OUTCOME MEASURES: The proportion of patients who received more than 1 dispensing of inhaled corticosteroid during the observation period. Additional outcomes measured the proportion of patients with 1 or more hospitalizations or ED visits. RESULTS: A significantly greater proportion of patients from the intervention group received more than 1 dispensing of inhaled corticosteroid compared with controls (relative risk [RR], 1.41; 95% confidence interval [CI], 1.08-1.72). We found no significant difference in the proportion of patients who were hospitalized (RR, 1.37; 95% CI, 0.48-3.71) or visited the ED (RR, 0.86; 95% CI, 0.49-1.40). CONCLUSIONS: The presence of an asthma management program may improve dispensing of inhaled corticosteroids to young patients with moderate or severe asthma, as recommended by national guidelines. This type of program may not have an effect on hospitalizations or ED visits.
OBJECTIVE: To assess the impact of an asthma management program on the dispensing of inhaled corticosteroids, hospitalizations, and emergency department (ED) visits on children, adolescents, and young adults. DESIGN: We used medical record and pharmacy data for the 18 months after initiation of a pilot asthma management program. Two intervention offices were matched with 2 control offices on pediatric volume, number of pediatricians or family practitioners, and specialist availability. SETTING: Primary care offices at Kaiser Permanente Colorado, in Denver and Boulder. PATIENTS: We identified 298 patients, 18 years or younger,who were listed in an asthma registry between February 1 and July 31, 1997, as having moderate or severe asthma. INTERVENTION: The Kaiser Permanente Colorado Asthma Care Management Program is an outpatient-based program that provides comprehensive evaluation, education, and follow-up to patients identified from an asthma registry or referred by providers. MAIN OUTCOME MEASURES: The proportion of patients who received more than 1 dispensing of inhaled corticosteroid during the observation period. Additional outcomes measured the proportion of patients with 1 or more hospitalizations or ED visits. RESULTS: A significantly greater proportion of patients from the intervention group received more than 1 dispensing of inhaled corticosteroid compared with controls (relative risk [RR], 1.41; 95% confidence interval [CI], 1.08-1.72). We found no significant difference in the proportion of patients who were hospitalized (RR, 1.37; 95% CI, 0.48-3.71) or visited the ED (RR, 0.86; 95% CI, 0.49-1.40). CONCLUSIONS: The presence of an asthma management program may improve dispensing of inhaled corticosteroids to young patients with moderate or severe asthma, as recommended by national guidelines. This type of program may not have an effect on hospitalizations or ED visits.
Authors: Michelle Boyd; Toby J Lasserson; Michael C McKean; Peter G Gibson; Francine M Ducharme; Michelle Haby Journal: Cochrane Database Syst Rev Date: 2009-04-15
Authors: Melissa H Bellin; Joan Kub; Kevin D Frick; Mary Elizabeth Bollinger; Mona Tsoukleris; Jennifer Walker; Cassie Land; Arlene M Butz Journal: J Pediatr Health Care Date: 2011-11-16 Impact factor: 1.812
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Authors: David Gustafson; Meg Wise; Abhik Bhattacharya; Alice Pulvermacher; Kathleen Shanovich; Brenda Phillips; Erik Lehman; Vernon Chinchilli; Robert Hawkins; Jee-Seon Kim Journal: J Med Internet Res Date: 2012-07-26 Impact factor: 5.428