To determine if a home asthma management program designed and delivered by respiratory therapists (RTs) is more effective in improving outcomes and reducing cost of care when compared to standard care or a program designed by nurses.
Adults treated for asthma exacerbation were offered participation in a three-group (control, nursing, RT), randomized, prospective study. Subjects in the control group (n=60) received standard care. Those in the nursing group (n=58) received home asthma care according to conventional nursing practices over a five week period. Those receiving an RT-designed home asthma management program (n=48) were seen by RTs over five weeks. Each treatment group received education on asthma, equipment use, and medication, as well as training on action to take in the event of an exacerbation. Subjects were followed for 6 months. Quality of life according to SF36 and St. George Respiratory Quotient, hospital and ED admissions, physician office visits, cost of care, asthma episode scores, and patient satisfaction were compared using ANOVA and Chi Square, with P<0.05 being considered significant.
Quality of life was improved in the RT group compared to nursing and control. Both nursing and RT groups had fewer ED and physician office visits than control. Cost of care was $3642/subj in the control group and $2324/subj and $2534/subj in the nursing and RT groups, respectively. Asthma episode scores (assessment of subjects’ knowledge of what to do during exacerbation) and patient satisfaction scores were higher in the RT group compared to nursing and control.
An asthma management program delivered in the home by nurses or RT’s results in fewer ED and physician office visits and lower cost of care. Quality of life, asthma episode scores, and patient satisfaction were highest in the RT-designed program.
A home asthma management program can reduce health care resource utilization and cost of care. An RT-designed asthma management program results in better quality of life, greater knowledge of asthma control, and more satisfaction with asthma care.
Jay Peters, None.