Improving asthma treatment in a managed care population

To identify and educate members of ConnectiCare, Inc & Affiliates, a regional managed care organization, who were not using asthma medications as recommended by the National Heart, Lung, and Blood Institute, by means of a nurse-administered 6-month telephonic case management intervention called the Asthma Treatment Awareness Project.

A randomized controlled design was used to evaluate intervention and control groups. Self-selected members who opted in, opted out, or did not respond to an invitation to participate were included in the analysis.

Changes in asthma medication use, physician office visits, emergency department visits, hospitalizations, and quality of life were measured. A change in asthma medication use was measured using an asthma medication index ranging from 0 to 1.00, with a higher score indicating a better prescribing pattern.

There was significant improvement in asthma medication use for all groups, but the asthma medication index increase of 0.176 for the intervention group was nearly 2 times the 0.091 increase for the control group. This difference remained significant (P = .04) after using analysis of variance to control for age and the preintervention asthma medication index. There was also a significant increase in overall quality of life for the intervention group (P = .04) but not for the control group.

Individualized telephonic case management from a specially trained registered nurse may be effective in improving asthma medication use and quality of life in subjects that do not use asthma medications according to National Heart, Lung, and Blood Institute guidelines.