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Effectiveness of an Asthma Management Program for Pediatric Members of a Large Health Maintenance Organization
Susan L. Lukacs, DO, MSPH;
Eric K. France, MD, MSPH;
Anna E. Barón, PhD;
Lori A. Crane, PhD, MPH
Arch Pediatr Adolesc Med. 2002;156:872-876.
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.
From the Department of Preventive Medicine and Biometrics, University
of Colorado Health Sciences Center, Denver (Drs Lukacs, France, Barón,
and Crane), and the Department of Preventive Medicine, Kaiser Permanente (Dr
France), Colorado, Denver. Dr Lukacs is now with the National Center for Health
Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Effects of Asthma Education on Children's Use of Acute Care Services: A Meta-analysis
Coffman et al.
Pediatrics 2008;121:575-586.
ABSTRACT
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