Physician asthma education program improves outcomes for children of low-income families.
OBJECTIVE
To determine whether an interactive physician seminar that has been shown to improve patient/parent satisfaction and to decrease emergency department visits for children with asthma was also effective for those children from low-income families.


METHODS
Seventy-four pediatricians and 637 of their patients were randomized to receive two asthma seminars or no educational programs and were observed for 2 years.


METHODS
Physicians in the New York, NY, and Ann Arbor, MI, areas were enrolled, and, on average, 10 patients with asthma per provider were surveyed and observed for 2 years.


METHODS
A total of 637 subjects were enrolled, and 369 subjects remained in the study after 2 years. Of these, 279 had complete medical and survey information.


METHODS
Physicians were randomized, and then a random sample of their patients was enrolled and surveyed regarding the physician's communication style, the child's asthma symptoms, medical needs, and asthma care. Low income was defined as annual income of < 20,000 dollars.


RESULTS
The families of 36 children (13%) had an income of < 20,000 dollars, and they were treated by 23 physicians. Low-income children in the treatment group tended to have higher levels of use of controller medications, to receive a written asthma action plan, and to miss fewer days of school, although these differences were not statistically significant compared to low-income children in the control group. However, low-income treatment group children were significantly less likely to be admitted to an emergency department (annual rate, 0.208 vs 1.441, respectively) or to a hospital (annual rate, 0 vs 0.029, respectively) for asthma care compared to children in the control group.


CONCLUSIONS
The educational program for physicians improved asthma outcomes for their low-income patients. Provider interventions targeted to these high-risk patients may diminish hospital and emergency department asthma care.
Department of Pediatrics, University of Michigan Health Sciences, Ann Arbor, USA.
Randall
R
Brown
Susan L
SL
Bratton
Michael D
MD
Cabana
Niko
N
Kaciroti
Noreen M
NM
Clark
D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004502:Education, Medical, Continuing; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D010353:Patient Education as Topic / Q000379:methods; D011203:Poverty; D014481:United States