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Related Experiment Videos

Improving asthma care through recertification: a cluster randomized trial.

Jan Simpkins1, George Divine, Mingqun Wang

  • 1Center for Health Services Research, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.

Archives of Internal Medicine
|November 14, 2007
PubMed
Summary
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An asthma-specific practice improvement module (PIM) did not increase inhaled corticosteroid (ICS) prescriptions but may reduce asthma severity by increasing trigger discussions.

Area of Science:

  • Internal Medicine
  • Pulmonology
  • Healthcare Quality Improvement

Background:

  • Physicians must complete practice improvement modules (PIMs) for recertification.
  • This study evaluated an asthma-specific PIM's impact on patient outcomes.

Purpose of the Study:

  • To determine if an asthma-focused PIM improves patient care and outcomes.
  • To assess the effect of PIM completion on inhaled corticosteroid (ICS) use and asthma severity.

Main Methods:

  • A cluster randomized trial involving 16 practices (39 internists).
  • Intervention group physicians completed an asthma PIM.
  • Primary outcome: ICS dispensing post-visit; secondary outcomes: patient-reported care, healthcare use, and asthma severity.

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Main Results:

  • No significant difference in ICS fill rates between groups (AOR 1.00, 95% CI 0.64-1.56).
  • Intervention group patients received fewer written action plans (AOR 0.67, 95% CI 0.48-0.93).
  • Intervention group patients were more likely to discuss triggers (AOR 1.62, 95% CI 1.08-2.42) and reported lower asthma severity.

Conclusions:

  • The asthma PIM did not improve ICS prescription rates.
  • Increased discussion of asthma triggers may contribute to reduced asthma severity.
  • Further research is needed to optimize PIMs for asthma management.