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Impact of a pediatric clinic-based multidisciplinary asthma education and management program
Michelle Condren1, James A Boger
1Departments of Pharmacy: Clinical and Administrative Sciences and Pediatrics, University of Oklahoma Colleges of Pharmacy and Medicine, Tulsa, Oklahoma.
Insights
A multidisciplinary asthma program in a pediatric clinic significantly reduced hospitalizations, emergency department visits, and corticosteroid use in children with asthma.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacy
- Healthcare Management
Background:
- Asthma is a chronic respiratory condition affecting millions of children.
- Effective asthma management requires a multidisciplinary approach.
- General pediatric clinics can serve as a setting for specialized asthma programs.
Purpose of the Study:
- To evaluate the clinical impact of a multidisciplinary asthma education and management program.
- To assess changes in hospitalizations, emergency department visits, and corticosteroid use.
- To determine the effectiveness of such a program in a general pediatric setting.
Main Methods:
- A multidisciplinary asthma clinic was established, involving a pediatrician, pharmacist, and nurse.
- Retrospective data collection on hospitalizations, ED visits, and systemic corticosteroid courses.
- Comparison of outcomes in the year before and the year after program enrollment for patients with at least one year of follow-up.
Main Results:
- A significant decrease in hospitalizations (82%), emergency department visits (81%), and systemic corticosteroid courses (72%) was observed.
- The study included 57 children with a mean age of 8.5 years.
- 48% had moderate persistent asthma, and 11% had severe persistent asthma.
Conclusions:
- Enrollment in a pediatric clinic-based multidisciplinary asthma program leads to improved clinical outcomes.
- The program effectively reduces severe asthma exacerbations and medication burden.
- This model demonstrates the value of integrated care in managing pediatric asthma.
Objective:
The objective of this study was to determine if a multidisciplinary asthma education and management program within a general pediatric clinic impacts clinical outcomes of children with asthma.
Methods:
An asthma education and management clinic was started by a general pediatrician, a pharmacist, and a nurse. At a patient's initial clinic visit, data were collected summarizing hospitalizations, emergency department visits, and number of systemic corticosteroid courses for the previous year. The same data were collected at each subsequent visit. A retrospective review of this data was performed for patients who enrolled in the clinic between February 1999 and 2002 to compare outcomes between the year before enrollment in the clinic and the following year. Patients were included if they received follow-up for at least one year.
Results:
Fifty-seven patients with a mean age of 8.5 years qualified for data analysis. Forty-eight percent of the study population was classified as having moderate persistent asthma, and 11% of patients were severe persistent. Compared to the year prior to clinic enrollment, the number of hospitalizations per patient decreased by 82% (P < .001). Emergency department visits decreased by 81% (P < .001). The number of systemic corticosteroid courses decreased by 72% (P < 0.001).
Conclusions:
Patient enrollment in a general pediatric clinic-based multidisciplinary asthma education and management program decreases hospitalizations, emergency department visits, and systemic corticosteroid exposure.
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