RATIONALE: Asthma is associated with significant morbidity. Previous studies highlight significant variations in asthma management approaches within primary care settings where the adoption of published asthma guidelines is typically suboptimal. OBJECTIVE: To determine whether the implementation of an evidence-based asthma care program in community primary care settings leads to improved clinical outcomes in asthma patients. METHODS, MEASUREMENTS, AND MAIN RESULTS: A community-based participatory research project was implemented at 8 primary care practices across Ontario, Canada, consisting of elements based on the Canadian Asthma Consensus Guidelines (asthma care map, program standards, management flow chart and action plan). A total of 1408 patients aged 2-55 years participated. Conditional logistic regression analyses were used to calculate the odds ratios (OR) comparing baseline to follow-up while adjusting for age, gender, socioeconomic status and other covariates. At 12-month follow-up, there were statistically significant reductions in self-reported asthma exacerbations from 77.8% to 54.5% [OR = 0.35; 95% confidence interval (CI): 0.28-0.43]; emergency room visits due to asthma from 9.9% to 5.5% (OR = 0.47; 95% CI: 0.32-0.62); school absenteeism in children from 19.9% to 10.2% (OR = 0.37; 95% CI: 0.25-0.54); productivity loss in adults from 12.0% to 10.3% (OR = 0.49; 95% CI: 0.34-0.71); uncontrolled daytime asthma symptoms from 62.4% to 41.4% (OR = 0.34; 95% CI: 0.27-0.42); and uncontrolled nighttime asthma symptoms from 46.4% to 25.4% (OR = 0.29; 95% CI: 0.23-0.37). CONCLUSIONS: Development and implementation of a community-based primary care asthma care program led to risk reductions in exacerbations, symptoms, urgent health service use and productivity loss related to asthma.
RATIONALE: Asthma is associated with significant morbidity. Previous studies highlight significant variations in asthma management approaches within primary care settings where the adoption of published asthma guidelines is typically suboptimal. OBJECTIVE: To determine whether the implementation of an evidence-based asthma care program in community primary care settings leads to improved clinical outcomes in asthmapatients. METHODS, MEASUREMENTS, AND MAIN RESULTS: A community-based participatory research project was implemented at 8 primary care practices across Ontario, Canada, consisting of elements based on the Canadian Asthma Consensus Guidelines (asthma care map, program standards, management flow chart and action plan). A total of 1408 patients aged 2-55 years participated. Conditional logistic regression analyses were used to calculate the odds ratios (OR) comparing baseline to follow-up while adjusting for age, gender, socioeconomic status and other covariates. At 12-month follow-up, there were statistically significant reductions in self-reported asthma exacerbations from 77.8% to 54.5% [OR = 0.35; 95% confidence interval (CI): 0.28-0.43]; emergency room visits due to asthma from 9.9% to 5.5% (OR = 0.47; 95% CI: 0.32-0.62); school absenteeism in children from 19.9% to 10.2% (OR = 0.37; 95% CI: 0.25-0.54); productivity loss in adults from 12.0% to 10.3% (OR = 0.49; 95% CI: 0.34-0.71); uncontrolled daytime asthma symptoms from 62.4% to 41.4% (OR = 0.34; 95% CI: 0.27-0.42); and uncontrolled nighttime asthma symptoms from 46.4% to 25.4% (OR = 0.29; 95% CI: 0.23-0.37). CONCLUSIONS: Development and implementation of a community-based primary care asthma care program led to risk reductions in exacerbations, symptoms, urgent health service use and productivity loss related to asthma.
Authors: Sande O Okelo; Arlene M Butz; Ritu Sharma; Gregory B Diette; Samantha I Pitts; Tracy M King; Shauna T Linn; Manisha Reuben; Yohalakshmi Chelladurai; Karen A Robinson Journal: Pediatrics Date: 2013-08-26 Impact factor: 7.124
Authors: Alexandrine J Lamontagne; Sandra Pelàez; Roland Grad; Lucie Blais; Kim L Lavoie; Simon L Bacon; Hélène Guay; Annie Gauthier; Martha L McKinney; Pierre Ernst; Johanne Collin; Francine M Ducharme Journal: Can Respir J Date: 2013 Jul-Aug Impact factor: 2.409
Authors: Christopher Licskai; Todd Sands; Michael Ong; Lisa Paolatto; Ivan Nicoletti Journal: Int J Qual Health Care Date: 2012-08-14 Impact factor: 2.038