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Published on: November 4, 2010
Improving asthma treatment in a managed care population
Steven Delaronde1, Dori L Peruccio, Bonnie J Bauer
1From Health Management Programs, ConnectiCare, Inc & Affiliates, Farmington, CT 06032, USA. sdelaronde@connecticare.com
The American Journal of Managed Care
|June 25, 2005
Summary
A nurse-led telephonic case management program improved asthma medication adherence and quality of life for patients not following National Heart, Lung, and Blood Institute guidelines. This intervention demonstrated better outcomes than standard care.
Area of Science:
- Health Services Research
- Pulmonology
- Nursing Interventions
Background:
- Many patients with asthma do not adhere to recommended medication guidelines from the National Heart, Lung, and Blood Institute.
- Suboptimal medication use can lead to poor asthma control and reduced quality of life.
Purpose of the Study:
- To assess the effectiveness of a nurse-administered telephonic case management program, the Asthma Treatment Awareness Project.
- To improve asthma medication use and quality of life in members of a managed care organization not following NHLBI guidelines.
Main Methods:
- A randomized controlled trial was conducted with intervention and control groups.
- The intervention involved a 6-month telephonic case management by a registered nurse.
- Asthma medication use (via an index), office visits, ED visits, hospitalizations, and quality of life were measured.
Main Results:
- The intervention group showed a significantly greater increase in the asthma medication index (0.176) compared to the control group (0.091).
- This improvement in medication use was statistically significant after controlling for age and baseline index (P = .04).
- The intervention group experienced a significant improvement in overall quality of life (P = .04), unlike the control group.
Conclusions:
- Individualized telephonic case management by a trained nurse can effectively enhance asthma medication adherence.
- This nursing intervention also improves the quality of life for patients not using asthma medications per NHLBI guidelines.
- Telephonic case management represents a viable strategy for improving asthma care within managed care settings.
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