Improving asthma treatment in a managed care population

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.