scholarly journals Impact of an asthma management program on hospitalizations and emergency department visits

2011 ◽  
Vol 87 (5) ◽  
pp. 412-8 ◽  
Author(s):  
Maria J. F. Fontes ◽  
Alessandra G. A. Affonso ◽  
Geralda M. C. Calazans ◽  
Cláudia R. de Andrade ◽  
Laura M. L. B. F. Lasmar ◽  
...  
2016 ◽  
Vol 29 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Khalid H. Safi ◽  
Karla J. Stoermer-Grossman ◽  
Kelley M. Kidwell ◽  
Julie M. Sturza ◽  
Ixsy A. Ramirez ◽  
...  

2020 ◽  
Author(s):  
Sebastiano Guarnaccia ◽  
Cristina Quecchia ◽  
Andrea Festa ◽  
Michele Magoni ◽  
Giuseppe Zenoni ◽  
...  

Abstract BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years so far. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that, an integrated DTEP program for preschool children not only can provide a real-world assessment for improved wheezing control, but also a measure for reduction of adverse therapeutic related outcomes.


2000 ◽  
Vol 7 (3) ◽  
pp. 255-260 ◽  
Author(s):  
John Reid ◽  
Darcy D Marciniuk ◽  
Donald W Cockcroft

OBJECTIVES:To evaluate various aspects of the management of adult patients who present to the emergency department with acute exacerbations of asthma and who are discharged from the emergency department without hospital admission. Further, to compare the results with accepted management guidelines for the emergency department treatment of asthma.DESIGN:A retrospective chart collection and review until each site contributed 50 patients to the survey.SETTING:Three tertiary care hospitals in the Saskatoon Health District, Saskatoon, Saskatchewan. The study period was from July 1, 1997 to November 18, 1997.POPULATION:Patients aged 17 years or older, who were discharged from the emergency department with the diagnosis of asthma.METHODS:Data were collected on 130 patients from 147 emergency department visits.RESULTS:A number of important physical examination findings were frequently not documented. In contrast to management guidelines, peak expiratory flow rates (44%) and spirometry (1%) were not commonly used in patient assessments. Only 59% of patients received treatment in the emergency departments with inhaled or systemic corticosteroids. Furthermore, specific follow-up plans were infrequently documented in the emergency department charts (37%).CONCLUSIONS:Adherence with published Canadian guidelines for the emergency department management of acute asthma exacerbations was suboptimal. Corticosteroid use in the emergency department was significantly less than recommended. Increased emphasis on education and implementation of accepted asthma management guidelines is necessary.


PEDIATRICS ◽  
2006 ◽  
Vol 117 (Supplement 2) ◽  
pp. S145-S151 ◽  
Author(s):  
Rodney B. Boychuk ◽  
Charles J. DeMesa ◽  
Kristi M. Kiyabu ◽  
Franklin Yamamoto ◽  
Loren G. Yamamoto ◽  
...  

2005 ◽  
Vol 10 (4) ◽  
pp. 254-258 ◽  
Author(s):  
Michelle Condren ◽  
James A Boger

OBJECTIVE The objective of this study was to determine if a multidisciplinary asthma education and management program within a general pediatric clinic impacts clinical outcomes of children with asthma. METHODS An asthma education and management clinic was started by a general pediatrician, a pharmacist, and a nurse. At a patient's initial clinic visit, data were collected summarizing hospitalizations, emergency department visits, and number of systemic corticosteroid courses for the previous year. The same data were collected at each subsequent visit. A retrospective review of this data was performed for patients who enrolled in the clinic between February 1999 and 2002 to compare outcomes between the year before enrollment in the clinic and the following year. Patients were included if they received follow-up for at least one year. RESULTS Fifty-seven patients with a mean age of 8.5 years qualified for data analysis. Forty-eight percent of the study population was classified as having moderate persistent asthma, and 11% of patients were severe persistent. Compared to the year prior to clinic enrollment, the number of hospitalizations per patient decreased by 82% (P < .001). Emergency department visits decreased by 81% (P < .001). The number of systemic corticosteroid courses decreased by 72% (P < 0.001). CONCLUSIONS Patient enrollment in a general pediatric clinic-based multidisciplinary asthma education and management program decreases hospitalizations, emergency department visits, and systemic corticosteroid exposure.


2018 ◽  
Vol 53 (9) ◽  
pp. 1737-1741 ◽  
Author(s):  
Carlos A. Reck-Burneo ◽  
Alejandra Vilanova-Sanchez ◽  
Alessandra C. Gasior ◽  
Alexander J.M. Dingemans ◽  
Victoria A. Lane ◽  
...  

2020 ◽  
Author(s):  
Sebastiano Guarnaccia ◽  
Cristina Quecchia ◽  
Andrea Festa ◽  
Michele Magoni ◽  
Giuseppe Zenoni ◽  
...  

Abstract BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have yet been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that a real-world assessment of the integrated DTEP program for preschool children provides evidence for improved wheezing control and reduction of adverse therapeutic related outcomes.


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