Respiratory Care Training for Safety-Net Primary Care Practices

Area of Science:

• Pulmonary Medicine
• Primary Care Innovation
• Healthcare Quality Improvement

Background:

• Asthma and COPD management in primary care has variable success.
• Broad implementation of effective programs remains a challenge.
• The Respiratory Toolkit was developed to address this gap.

Purpose of the Study:

• To evaluate the impact of the Respiratory Toolkit on asthma and COPD diagnosis and management in primary care.
• To assess changes in guideline-based care following program implementation.

Main Methods:

• A 2-year program involving interactive training, in-clinic follow-ups, EMR tools, and patient resources was implemented.
• The study was conducted in an urban federally qualified health center with 13 clinics and 87 staff.
• Data was collected on the use of spirometry, severity assessment, action plans, medication prescriptions, and screening tools.

Main Results:

• Significant increases in spirometry use for both asthma (7% to 43%) and COPD (21% to 35%) patients.
• Improved asthma action plan use (2% to 8%) and inhaled corticosteroid prescriptions (33% to 42%).
• Enhanced COPD screening (0% to 11%) and spirometry use (4% to 36%) among undiagnosed smokers.

Conclusions:

• The Respiratory Toolkit led to significant improvements in guideline-based asthma and COPD care.
• Barriers such as time constraints hindered full program adoption.
• Further strategies may be needed to overcome implementation challenges.