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Can a community evidence-based asthma care program improve clinical outcomes?: a longitudinal study
Teresa To1, Lisa Cicutto, Naushaba Degani
1Department of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. teresa.to@sickkids.ca
Medical Care
|March 21, 2009
Summary
Implementing an evidence-based asthma care program in primary care significantly reduced asthma exacerbations, symptoms, and emergency visits. This community-based approach improved patient outcomes and reduced healthcare utilization.
Area of Science:
- Primary Care Research
- Public Health Interventions
- Respiratory Medicine
Background:
- Asthma significantly contributes to morbidity, with suboptimal guideline adoption in primary care.
- Variations in asthma management within primary care settings necessitate improved strategies.
Purpose of the Study:
- To evaluate the impact of an evidence-based asthma care program on clinical outcomes in primary care.
- To assess the effectiveness of a community-based participatory research project for asthma management.
Main Methods:
- An evidence-based asthma care program, incorporating Canadian Asthma Consensus Guidelines, was implemented across 8 primary care practices.
- 1408 patients (aged 2-55) participated in this community-based participatory research project.
- Conditional logistic regression analyses compared baseline to 12-month follow-up outcomes.
Main Results:
- Statistically significant reductions were observed in asthma exacerbations (77.8% to 54.5%), emergency room visits (9.9% to 5.5%), and school absenteeism (19.9% to 10.2%).
- Improvements included decreased productivity loss in adults (12.0% to 10.3%) and reduced uncontrolled daytime (62.4% to 41.4%) and nighttime (46.4% to 25.4%) asthma symptoms.
- Odds ratios indicated significant risk reductions across all measured outcomes.
Conclusions:
- A community-based primary care asthma care program effectively reduced exacerbations, symptoms, and urgent healthcare use.
- The program demonstrated success in mitigating productivity loss associated with asthma.
- Implementation of guideline-based asthma care programs in primary settings improves patient outcomes.
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