Targeted intervention programs: creating a customized practice model to improve the treatment of allergic rhinitis in a managed care population.
OBJECTIVE
To develop an intervention program to improve health outcomes among patients with allergic rhinitis in a managed care environment.


METHODS
The Episodes of Care (EOC) team at Lovelace Health Systems selected allergic rhinitis for an intervention program because it was identified as one of the top 10 reasons for visits to primary care clinics. The intervention program was based on a multidisciplinary team process designed to create a customized provider and patient education program to alter inconsistence or deficiencies in the treatment of allergic rhinitis.


METHODS
The EOC team researched literature and current practices and then identified inconsistencies in diagnostic and treatment patterns. Based on this research, the team developed guidelines and a provider education program. Intervention strategies were structured around decision points in a treatment protocol. More than 500 patients were monitored throughout the allergy season by using written and telephone surveys, symptom diaries, and encounter data. Measurable outcomes were established for provider and patient behavior. Patient outcomes were derived from a preventive behavior index and administrative data reporting usage of 5 classes of medication.


RESULTS
Approximately 50% of providers altered their practice patterns as a result of the intervention program. Patient outcomes showed a decrease in the use of rescue medications, particularly antibiotics, and an increase in preventive measures in the treatment group compared with the control group.


CONCLUSIONS
The EOC model resulted in positive changes in provider and patient behavior. The multidisciplinary approach resulted in broad provider participation.
Gregory
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C
Lovelace Clinic Foundation, Albuquerque, NM 87108, USA.
Cifaldi
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Tanner
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LA
D000465:Algorithms; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D003363:Cost Control; D003937:Diagnosis, Differential; D017050:Episode of Care; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D009516:New Mexico; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control
D018926:Anti-Allergic Agents