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  • Title: Outcomes of a population-based asthma management program: quality of life, absenteeism, and utilization.
    Author: Legorreta AP, Leung KM, Berkbigler D, Evans R, Liu X.
    Journal: Ann Allergy Asthma Immunol; 2000 Jul; 85(1):28-34. PubMed ID: 10923601.
    Abstract:
    BACKGROUND: Despite the availability of the National Asthma Education Program (NAEP) guidelines since 1991, asthma remains inadequately managed. To improve quality of life, functional status, and self-management behavior of asthma patients, a large health maintenance organization (HMO) in California implemented an asthma management program in 1996. OBJECTIVE: To evaluate the effectiveness of an asthma management program in an HMO setting. DESIGN AND SETTING: Prospective study. Survey data from members who participated in the intervention program and data from members who received usual care were analyzed using propensity score technique. RESULTS: A total of 1,043 asthma patients who responded both baseline and follow-up survey were included in the analysis. From baseline to followup, participants in the in-home intervention program reported significant improvement in functional status (improvements range from 0.2 to 7.2), daily use of steroid inhaler (+4.1%), daily peak flow meter use (+6.4%), self-reported knowledge of what to do for an asthma attack (+12.4%), and feeling that their asthma was under control (+10.8%). Absenteeism (-11.8%) and hospitalization due to asthma (-3.5%) were significantly reduced from baseline to follow-up. Participants did not report significant changes in overuse of beta2-agonists and emergency room visits due to asthma. In comparison with the asthmatic patients who received usual care (non-participants), participants had significantly greater improvement on daily use of steroid inhaler (+4.0% versus -6.0%), daily use of home peak flow meter (+6.4% versus 1.9%) and self-reported knowledge on what to do for an asthma attack (+12.4% versus +5.4%). CONCLUSION: These findings suggest that population-based programs can improve functional status, increase self-monitoring and knowledge about asthma, and decrease absenteeism and hospitalization for asthma by directly providing asthmatic patients with educational materials and self-monitoring tools. Such "direct-to-consumer" outreach programs may help bridge the gap between NAEPs 1991 practice guidelines and the reality of current asthma management.
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