An interdisciplinary intervention for undertreated pediatric asthma.
OBJECTIVE
To examine the effectiveness of an interdisciplinary intervention for pediatric asthma.


METHODS
Randomized, controlled study.


METHODS
Urban tertiary-referral pediatric hospital.


METHODS
One hundred seventy-five patients with asthma lacking written treatment plans and presenting with asthma-related emergency department visits (two or more) and/or hospitalizations (one or more) in the past year were randomized to a comparison group receiving medical care alone (n = 86) or to an interdisciplinary intervention group receiving medical care, asthma education, and problem-solving therapy (n = 89)


METHODS
All participants received written asthma management plans, peak flow meters, and spacer devices. The intervention group also received asthma education, an asthma risk profile assessment, brief problem-solving therapy, and access to a 24-h nurse advice line. The primary outcome measure was change in asthma symptoms, and secondary outcomes included health-care utilization and asthma-related quality of life.


RESULTS
Both groups demonstrated significant reductions in asthma symptoms and improvements in quality of life without any between-group differences identified over the course of follow-up. In contrast, the intervention group demonstrated less frequent health-care utilization than the comparison group, with 28% of the intervention group requiring emergency department or inpatient services for asthma compared to 41% of the comparison group (adjusted odds ratio, 1.92; 95% confidence interval, 1.00 to 3.69) over the 12-month follow-up period.


CONCLUSIONS
This study examined the effectiveness of an interdisciplinary intervention for undertreated asthma. The intervention did not result in improvements in asthma symptoms, but accomplished modest reductions in the utilization of acute medical care.
Walders
Natalie
N
National Jewish Medical and Research Center, Denver, CO. Electronic address: waldersn@njc.org.
Kercsmar
Carolyn
C
Case School of Medicine, Cleveland, OH.
Schluchter
Mark
M
Case School of Medicine, Cleveland, OH.
Redline
Susan
S
Case School of Medicine, Cleveland, OH.
Kirchner
H Lester
HL
Case School of Medicine, Cleveland, OH.
Drotar
Dennis
D
Rainbow Babies and Children's Hospital, Cleveland, OH.
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010353:Patient Education as Topic; D010366:Peak Expiratory Flow Rate; D011788:Quality of Life; D012648:Self Care
D018927:Anti-Asthmatic Agents