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Impact of Innovative Model of Inpatient Asthma Disease Management Program on Patient Outcomes FREE TO VIEW

Vivian Knieper, Asthma Educator; Catherine Meldrum, RN; William F. Bria, MD
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University of Michigan, Ann Arbor, MI


Chest. 2003;124(4_MeetingAbstracts):95S. doi:10.1378/chest.124.4_MeetingAbstracts.95S
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PURPOSE:  Asthma disease management (ADM) studies have suggested benefits of improved asthma control and decreased health-resource utilization. Our purpose was to investigate the effectiveness of a new model of asthma disease management for adult inpatients with acute asthma at the University of Michigan Hospital and Health Systems (UMHHS) involving a multidisciplinary team. Team members include: 1. Asthma Educator/Coordinator, 2. Third year medical students on rotation trained in the ADM program at the beginning of every month, 3. Inpatient nursing, and 4. Respiratory Therapists.

METHODS:  Patients were identified as candidates for ADM by a team member. After obtaining informed consent, patients were provided introductory educational materials including: 1. Patient ADM orientation, 2. Instruction in both peak flow monitoring and MDI spacer use, 3. Written ADM Care Plan. The patients proficiency in the information and techniques was collaboratively documented by Med students, MDs, RN, and RT. Subsequent patient contact and data collection was via telephone at 2 weeks, 4 months and 1 year after hospitalization.

RESULTS:  42 Patients admitted to the adult inpatient service at UMMHS from 1/2001 thru 7/2002 Mean age was 47±16, Female/male ratio was 2:1. Patient data compared 1 year before intervention to 1 year post. For the first patient cohort completing a full years worth of data collection the following observations were made: Significant reductions were noted in 1. Hospitalizations, 2. Emergency room visits, 3. Unscheduled MD office visits. Significant improvement was noted in patient perception of disease control. Estimated total savings as a result of this intervention was $130,000.CONCLUSIONS: ADM can be effectively provided in adults admitted with acute asthma employing a multidisciplinary healthcare team, and achieve improvements in patient symptoms as well as decreased health resource utilization over one year following the intervention.

CLINICAL IMPLICATIONS:  ADM delivered by a multidisciplinary team during hospitalization for asthma can result in benefits in resource utilization and improved asthma control.

DISCLOSURE:  W.F. Bria, None.

Tuesday, October 28, 2003

10:30 AM - 12:00 PM




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