PURPOSE: To determine if an asthma education intervention aimed at primary care practices can improve asthma care for children they follow and be maintained after cessation of the intervention. To determine if results vary by intervention duration of 6 or 12 months.
METHODS: Ten practices were selected and were randomly assigned to one of 2 intervention groups. Group 1 (12 month intervention) and Group 2 (6 month intervention). Both groups included 5 pediatric primary care practices and two from each interventional group were “urban” practices. Inclusion criteria: voluntary participation, ability to identify one specialized non-physician designee for asthma care provider/practice. Program included visits from asthma educator every 2 weeks. Group 1 received early intervention for 12 months and was then monitored for 6 additional months and Group 2 was observed for 12 months and then intervention for 6 months and then monitoring for 6 additional months. Baseline survey and blinded chart review determined adequacy of documentation. Targeted questionnaire was done at 6 month intervals.
RESULTS: In group 1, 6 month, 12 month and 18 month data (mean and exact 95% binomial confidence intervals) revealed significant improvement in documentation of asthma severity level, asthma education, asthma action plan, asthma management according to NIH guidelines compared to baseline. There was also significant improvement in documentation of day time, night ime and exercise related symptoms compared to baseline. Improvement was significant compared to group 2 at 6 and 12 month interval. In group 2, intervention started at 12 months and improvement in all of the above endpoints was noted at 18 months. At end of intervention and end of the follow-up evaluation, there was no significant difference in any end point between group 1 and 2.
CONCLUSIONS: Asthma education at primary care offices does improve asthma care during and following the intervention as reflected by documentation. Equal effects are seen following 6 month and 12 month long intervention.
CLINICAL IMPLICATIONS: Asthma education programs targeting primary care practices do improve asthma care and be maintained after cessation of the intervention and results do not vary by intervention duration of 6 or 12 months.
DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Muffy Chrysler, Karen McCoy
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