Our institution has a fully operational multi-disciplinary Asthma Center (“Full Asthma Center” or FAC) in which patients with difficult-to-control asthma (DTCA) are evaluated and treated. We measured quality of life outcomes at baseline, one month and six months to determine whether patients showed improvement.
Patients with DTCA who were evaluated in the FAC were assessed by a pulmonologist, allergist, nurse and pharmacist (LM). Treatment decisions were made after a group meeting of the FAC team. The patient received intensive asthma education. We assessed patients using the Asthma Quality of Life Questionnaire (AQLQ) and classified the severity of their asthma using the 1997 NAEP guidelines: mild intermittent (1), mild persistent (2), moderate persistent (3) and severe persistent (4). Other measures included inhaled corticosteroid (ICS) use, compliance with medications and the use of an action plan. Data were collected before or during the first visit, after one month and after six months.
AQLQ scores and NAEP severity of asthma classification scores are summarized in the attached table.
BaselineOne monthSix monthsAQLQ score (1-7) (mean, range)3.8 (1.6-6.6) n=695.0 (2.1-6.8) n=435.1 (2.6-6.7) n=34BaselineOne monthSix monthsNHLBI Classification (1-4) (mean)3.4 n=722.8 n=512.6 n=39Asthma symptoms (1-4) (mean)3.0 n=762.0 n=541.9 n=39Rescue medication use (1-4) (mean)2.9 n=701.7 n=511.9 n=38Peak flow (1-4) (mean)2.6 n=692.6 n=492.4 n=29The overall AQLQ score improved from 3.8 to 5.0 at one month and 5.1 at six months. The overall NAEP classification improved from 3.4 at baseline to 2.8 at one month and 2.6 at six months. Patients using ICS increased from 72% at baseline to 92% at one month and 82% at six months. 66% were found to be compliant with their medications at baseline, compared to 88% at one month and 87% at six months. No patients used an action plan at baseline, compared to 98% at one month and 100% at six months.
Patients with DTCA who underwent treatment at our FAC showed significant improvement over six months in AQLQ scores, severity of asthma, use of ICS and compliance with their medical regimen.
A multi-disciplinary asthma center can improve the quality of life of patients with DTCA.
A.G. Villanueva, None.