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A Population-Based Approach to Asthma Disease Management

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Disease Management and Health Outcomes

Abstract

Asthma disease management (DM) programmes often focus on patients who are considered to be high resource users, such as those with recent emergency department visits and/or hospitalisations, or patients who have been diagnosed with severe persistent asthma. These programmes often focus on a few patients who have acute needs, but may not identify the populations with the highest future resource use. A population-based approach to disease management focuses on identifying deficiencies in asthma management across the population diagnosed with the disease and establishes a partnership between the patient, provider and healthcare plan to improve the overall quality of asthma care. The disease management approach described in this article is population-based, and is intended to raise the standard of medical care across a spectrum of patients with asthma.

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References

  1. Center for Disease Control. Forecasted state-specific estimates of self-reported asthma prevalence — United States. MMWR Morbid Mortal Wkly Rep 1998 Dec 4; 47: 1022–5

    Google Scholar 

  2. National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma expert panel report 2: clinical practice guidelines. Bethesda (MD): National Heart, Lung and Blood Institute, 1997 Apr

    Google Scholar 

  3. Wang E, Gaebel KA. The burden of asthma symptoms and the positive role of patient management. Dis Manage Health Outcomes 1999 Aug; 6(2): 83–91

    Article  CAS  Google Scholar 

  4. Epstein RS, Sherwood LM. From outcomes research to disease management: a guide for the perplexed. Ann Intern Med 1996; 124: 832–7

    PubMed  CAS  Google Scholar 

  5. Mayo PH, Richman J, Harris HW. Results of a program to reduce admissions for adult asthma. Ann Intern Med 1990; 112: 864–71

    PubMed  CAS  Google Scholar 

  6. Bailey WC, Richards JM, Brooks CM, et al. A randomized trial to improve self-management practices of adults with asthma. Arch Intern Med 1990; 150: 1665–8

    Article  Google Scholar 

  7. Bolton MB, Tilley BC, Kuder J, et al. The cost and effectiveness of an educational program for adults who have asthma. J Gen Intern Med 1991; 6: 401–7

    Article  PubMed  CAS  Google Scholar 

  8. Yoon R, McKenzie DK, Bauman A, et al. Controlled trial evaluation programme for adults. Thorax 1993; 48: 1110–6

    Article  PubMed  CAS  Google Scholar 

  9. Nelsen LM, Markson LE, Berger M. Persistence of emergency department use among asthma [abstract]. Am J Resp Crit Care Med 1998; 157(3): A221

    Google Scholar 

  10. O’Brien KP. Asthma in the managed care setting. Curr Opin Pulm Med 1997; 3: 56–60

    Article  PubMed  Google Scholar 

  11. Kerlinger FN. Foundation of behavioral research. 3rd ed. Philadelphia (PA): Harcourt Brace, 1985 Oct: 296–8

    Google Scholar 

  12. Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology: the essentials. 3rd ed. Baltimore (MD): Lippincott, Williams and Wilkins, 1988: 38

    Google Scholar 

  13. Nash DR, Childs GE, Kelleher KJ. A cohort study of resource use by medicaid children with asthma. Pediatrics 1999; 104: 310–2

    Article  PubMed  CAS  Google Scholar 

  14. Shelley M, Croft P, Chapman S, et al. Is the ratio of inhaled corticosteroid to bronchodilator a good indicator of the quality of asthma prescribing? Cross-sectional study linking prescribing data to data on admissions. BMJ 1996; 313: 1124–6

    Article  PubMed  CAS  Google Scholar 

  15. Roberts SJ. Ratio of inhaled corticosteroid to bronchodilator as an indicator of quality of asthma prescribing: authors discuss a result that was not shown. BMJ 1997; 314(7081): 680–1

    Article  PubMed  CAS  Google Scholar 

  16. Diette GB, Wu AW, Skinner EA, et al. Treatment patterns among adult patients with asthma: factors associated with overuse of inhaled beta-agonists and underuse of inhaled corticosteroids. Arch Intern Med 1999; 159: 2697–704

    Article  PubMed  CAS  Google Scholar 

  17. Cockcroft DW, Sywstun VA. Asthma control versus severity. J Allergy Clin Immunol 1996; 98(Pt 1): 1016–8

    Article  PubMed  CAS  Google Scholar 

  18. Colice GL, Vanden Burgt J, Song J, et al. Categorizing asthma severity. Am J Respir Crit Care Med 1999; 160: 1962–7

    PubMed  CAS  Google Scholar 

  19. Nguyen BP, Wilson SR, German DF. Patients’ perceptions compared with objective ratings of asthma severity. Ann Allergy Asthma Immunol 1996; 77: 209–15

    Article  PubMed  CAS  Google Scholar 

  20. Estey A, Musseau A, Keehn L. Comprehension levels of patients reading health information. Patient Educ Couns 1991; 18: 165–9

    Article  Google Scholar 

  21. Meade CD, Smith CF. Readibility formulas: cautions and criteria. Patient Educ Couns 1991; 17: 153–8

    Article  Google Scholar 

  22. Vollmer WM, Markson L, Frazier EA, et al. Screening for asthma management issues: initial results from a validation study [abstract]. Am J Respir Crit Care Med 1998; 157(3): A221

    Google Scholar 

  23. Diette GB, Markson L, Skinner EA, et al. Disease management targets in pediatric asthma care [abstract]. Am J Respir Crit Care Med 1999; 159(3): A141

    Google Scholar 

  24. Wu AW, Algatt-Bergstrom PJ, Diette GB, et al. Development of the pediatric asthma control score [abstract]. Am J Respir Crit Care Med 1999; 159(3): A911

    Google Scholar 

  25. Abdulwadud O, Abramson M, Forbes A, et al. Evaluation of a randomised controlled trial of adult asthma education in a hospital setting. Thorax 1999 Jun; 54: 493–500

    Article  PubMed  CAS  Google Scholar 

  26. Bartlett EE, Grayson M, Barket R, et al. The effects of physician communications skills on patient satisfaction. J Chronic Dis 1984; 37: 755–64

    Article  PubMed  CAS  Google Scholar 

  27. Wilson SR, Scamagas P, German DF, et al. A controlled trial of two forms of self-management education for adults with asthma. Am J Med 1993; 94: 564–76

    Article  PubMed  CAS  Google Scholar 

  28. Brody DS, Miller SM, Lerman CE, et al. The relationship between patients’ satisfactions with their physicians and perceptions about interventions they desired and received. Med Care 1989; 27: 1027–35

    Article  PubMed  CAS  Google Scholar 

  29. Feletti G, Firman D, Sanson-Fisher R. Patient satisfaction with primary care consultations. J Behav Med 1986; 9: 389–99

    Article  PubMed  CAS  Google Scholar 

  30. Chambers CV, Markson L, Diamond JJ, et al. Health beliefs and compliance with inhaled corticosteroids by asthmatic patients in primary care practices. Respir Med 1999; 93: 88–94

    Article  PubMed  CAS  Google Scholar 

  31. Laine C, Davidoff F, Lewis CE, et al. Important elements of outpatient care: a comparison of patients’ and physicians’ opinions. Ann Intern Med 1996; 125: 640–5

    PubMed  CAS  Google Scholar 

  32. Lieu TA, Quesenberry CP, Capra AM, et al. Outpatient management practices associated with reduced risk of pediatric asthma hospitalization and emergency department visits. Pediatrics 1997; 100: 334–41

    Article  PubMed  CAS  Google Scholar 

  33. Turner MO, Taylor D, Bennett R, et al. A randomized trial comparing peak expiratory flow and symptom self-management plans for patients with asthma attending a primary care clinic. Am J Respir Crit Care Med 1998; 157: 540–6

    PubMed  CAS  Google Scholar 

  34. Haponik EE, Richards B, Camp G, et al, and the North Carolina Medical School Consortium. Modifications of medical student education about asthma are necessary [abstract]. Chest 1994; 106: 154s

    Google Scholar 

  35. Davis D, O’Brien MA, Freemantle N, et al. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 1999 Sep; 282(9): 867–74

    Article  PubMed  CAS  Google Scholar 

  36. McLemore T, DeLozier J. Summary of 1985 National Ambulatory Medical Care Survey: advance data from vital and health statistics. Hyattsville (MD): Public Health Service, 1987; no. 128

    Google Scholar 

  37. Hayward RSA, Wilson MC, Tunis SR, et al. Practice guidelines: what are internists looking for? J Gen Intern Med 1996; 11: 176–8

    Article  PubMed  CAS  Google Scholar 

  38. Weingarten SR, Riedinger MS, Conner L, et al. Practice guidelines and reminders to reduce duration of hospital stay for patients with chest pain. Ann Intern Med 1994; 120: 257–63

    PubMed  CAS  Google Scholar 

  39. George M. Disease management approaches to asthma: what does it mean for the patient? Dis Manage Health Outcomes 1998; 6: 279–91

    Google Scholar 

  40. Lomas J, Enkin M, Anderson GM, et al. Opinion leaders vs audit and feedback to implement practice guidelines. JAMA 1991; 265: 2202–7

    Article  PubMed  CAS  Google Scholar 

  41. Creer TL, Backial M, Burns KL, et al. Living with asthma: part I. Genesis and development of a self-management program for childhood asthma. J Asthma 1988; 25: 335–62

    Article  PubMed  CAS  Google Scholar 

  42. Surveyor guidelines for the accreditation of MCOs: effective July 1, 2000–June 30, 2001. Washington, DC: National Committee for Quality Assurance, 1999

  43. Davis DA. Does CME work? An analysis of the effect of educational activities on physician performance or health care outcomes. Int J Psychiatry Med 1998; 28: 21–39

    Article  PubMed  CAS  Google Scholar 

  44. Rubin RJ, Dietrich KA, Hawk AD. Clinical and economic impact of implementing a comprehensive diabetes management program in managed care. J Clin Endocrinol Metab 1998; 83: 2635–42

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors would like to acknowledge Leslye Fitterman, PhD, for her contributions to the development and validation of the Asthma Therapy Assessment Questionnaire and Nittaya Suppapanya, MS, for data analysis support.

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Authors and Affiliations

  1. Merck & Co. Inc., US Human Health, P.O. Box 4, West Point, Pennysylvania, 19486-0004, USA

    Pamela J. Algatt-Bergstrom (pharmacist and Doctor of Pharmacy), Leona E. Markson, Richard K. Murray & Marc L. Berger

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  1. Pamela J. Algatt-Bergstrom
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  2. Leona E. Markson
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  3. Richard K. Murray
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  4. Marc L. Berger
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Correspondence to Pamela J. Algatt-Bergstrom.

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Algatt-Bergstrom, P.J., Markson, L.E., Murray, R.K. et al. A Population-Based Approach to Asthma Disease Management. Dis-Manage-Health-Outcomes 7, 179–186 (2000). https://doi.org/10.2165/00115677-200007040-00001

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