title: Disease management programs for patients with asthma in Germany: a longitudinal population-based study.
abstract: BACKGROUND
  The primary aim of the disease management program (DMP) for patients with asthma is to improve health outcomes and to reduce costs. Five years after its introduction in Germany, no consensus has yet been reached as to whether DMP has been effective in reaching these goals.
  
  
  OBJECTIVE
  To evaluate the DMP for asthma in Bavaria using routinely collected subject medical records.
  
  
  METHODS
  A longitudinal population-based study encompassing over 100,000 DMP participants between 2006 (when the program began) and 2010.
  
  
  RESULTS
  The prescription rate of oral corticosteroids dropped from 15.7% in 2006 to 13.6% in 2007, and again from 7.5% in 2008 to 5.9% in 2010 (P < .001). The proportion of subjects with asthma self-management education increased from 4.4% to 23.4% (P < .001). Utilization of an individual asthma action plan increased from 40.3% to 69.3% (P < .001). Hospitalization decreased from 2.8% to 0.7% (P < .001).
  
  
  CONCLUSIONS
  In the first 4 years of DMP there was an improvement in pharmacotherapy and patient self management. The proportion of subjects requiring hospitalization decreased. Our results suggest that the German DMP for asthma has been effective in enhancing the quality of care in regard to an improved symptom frequency, adherence to guidelines, pharmacotherapy, and hospitalization.
authors.affiliation: Institute of General Practice, Technische Universität München, Orleansstraße 47, Munich, Germany. michael.mehring@lrz.tum.de
authors.forename: Michael
authors.initials: M
authors.lastname: Mehring
authors.forename: Ewan
authors.initials: E
authors.lastname: Donnachie
authors.forename: Robert
authors.initials: R
authors.lastname: Mutschler
authors.forename: Frank
authors.initials: F
authors.lastname: Hofmann
authors.forename: Manfred
authors.initials: M
authors.lastname: Keller
authors.forename: Antonius
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology / Q000628:therapy; D002648:Child; D019468:Disease Management; D005260:Female; D058006:General Practice / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008501:Medical Records, Problem-Oriented; D054539:Medication Therapy Management; D010353:Patient Education as Topic; D010358:Patient Participation; D015397:Program Evaluation; D058996:Quality Improvement; D012648:Self Care / Q000706:statistics & numerical data*
chemical_list: D000305:Adrenal Cortex Hormones