title: Impact of a care manager on the outcomes of higher risk asthmatic patients: a randomized controlled trial.
abstract: Asthma care management programs may improve outcomes, but it is not clear which aspects of such management are responsible for the improvement. We performed a randomized controlled trial of a limited intervention (one visit with asthma self-management education and provision of inhaled budesonide) compared to this visit plus regular asthma care manager follow-up. Quality of life, symptom-free days, emergency hospital care, and beta-agonist dispensings did not differ between groups at 12 months. Patients who entered the study did receive significantly less beta-agonists in the follow-up year than patients who did not enter the study. These data suggest that the limited intervention in our setting improved outcomes but that regular care manager follow-up thereafter did not add significantly to this intervention.
authors.affiliation: Department of Allergy, Kaiser Permanente Medical Care Program, San Diego, California 92111, USA. michael.x.schatz@kp.org
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Carlene
authors.initials: C
authors.lastname: Gibbons
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelle
authors.forename: Kathleen
authors.initials: K
authors.lastname: Harden
authors.forename: Robert S
authors.initials: RS
authors.lastname: Zeiger
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000628:therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage; D004363:Drug Utilization; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000379:methods*; D018802:Patient-Centered Care; D011788:Quality of Life; D012306:Risk; D012959:Socioeconomic Factors
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D019819:Budesonide