A randomized clinical trial to reduce asthma morbidity among inner-city children: Results of the National Cooperative Inner-City Asthma Study

Evans, Richard; Gergen, Peter J.; Mitchell, Herman; Kattan, Meyer; Kercsmar, Carolyn M.; Crain, Ellen F.; Anderson, John A.; Eggleston, Peyton A.; Malveaux, Floyd J.; Wedner, H. James

doi:10.1016/s0022-3476(99)70130-7

Cited by 325 publications

(253 citation statements)

References 24 publications

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“…Regular follow-up is recommended to ensure correct use of prescribed drugs and to reinforce the patient9s and caregiver9s knowledge of asthma and management of the disease. Various intervention studies have demonstrated that patient education, mainly provided by an asthma nurse, resulted in better control of childhood asthma [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

Kamps¹,

Roorda²,

Kimpen³

et al. 2004

Eur Respir J

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The high burden of asthma on healthcare utilisation and costs warrants economic appraisal of management approaches. The authors previously demonstrated that the efficacy of nurse-led outpatient management of childhood asthma was comparable to management by a paediatrician and now report on the healthcare utilisation and costs of both management approaches.A total of 74 newly referred children with asthma were randomly assigned to a 1-yr follow-up by paediatricians or asthma nurse. Healthcare utilisation was recorded and associated costs calculated for both management approaches.There were no significant differences in healthcare utilisation except for the total time spent on patient contact (136(n=14) versus 187(n=41) min, for patients followed-up by paediatrician and an asthma nurse repectively). Costs within the healthcare sector were reduced by 7.2% in favour of nurse-led care. The reduction in costs was solely attributable to a 17.5% reduction in the costs of outpatient visits. Nurse-led care appeared to be cost-saving even if the duration of follow-up visits would be twice that of doctor9s visits. Overall healthcare costs (within and outside the healthcare sector) were 4.1% lower for nurse-led outpatient management compared to traditional medical care.Nurse-led outpatient management of childhood asthma can be provided at a lower cost than medical care by paediatricians.

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Section: Introductionmentioning

confidence: 99%

Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

Kamps¹,

Roorda²,

Kimpen³

et al. 2004

Eur Respir J

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“…2 A number of guidelines have been published (eg, the National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma, also known as EPR-3 3 ), and following guideline treatment recommendations improves clinical outcomes. [4][5][6] However, health care providers do not routinely follow asthma guideline recommendations, 7,8 resulting in substandard care and poor health outcomes. [9][10][11][12][13][14] One of the shortcomings of asthma guidelines is the limited extent to which health care providers are provided with tools to follow the recommended care.…”

mentioning

confidence: 99%

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

Butz²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Health care provider adherence to asthma guidelines is poor. The objective of this study was to assess the effect of interventions to improve health care providers' adherence to asthma guidelines on health care process and clinical outcomes. RESULTS: Sixty-eight eligible studies were classified by intervention: decision support, organizational change, feedback and audit, clinical pharmacy support, education only, quality improvement/pay-forperformance, multicomponent, and information only. Half were randomized trials (n = 35). There was moderate evidence for increased prescriptions of controller medications for decision support, feedback and audit, and clinical pharmacy support and low-grade evidence for organizational change and multicomponent interventions. Moderate evidence supports the use of decision support and clinical pharmacy interventions to increase provision of patient self-education/asthma action plans. Moderate evidence supports use of decision support tools to reduce emergency department visits, and low-grade evidence suggests there is no benefit for this outcome with organizational change, education only, and quality improvement/pay-for-performance. METHODS:CONCLUSIONS: Decision support tools, feedback and audit, and clinical pharmacy support were most likely to improve provider adherence to asthma guidelines, as measured through health care process outcomes. There is a need to evaluate health care provider-targeted interventions with standardized outcomes. Pediatrics 2013;132:517-534

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“…The city faces major economic challenges as 27% of the population lives below the poverty line, ranking the city as the 37th poorest city in the nation. According to the 2000 census statistics, 24% of Springfield residents have less 6 Evans R. …”

Section: Study Settingmentioning

confidence: 99%

“…The NCICAS demonstrated that an individually tailored family centered intervention carried out by masters-level social workers trained in asthma management could reduce asthma symptoms among poor, inner-city children. 6 This study examines the impact that the ICAI program has by comparing parents'…”

mentioning

confidence: 99%

Asthma Management Survey of Participants in an Inner City Asthma Intervention

Sadof¹,

Brandt

2007

SSRN Journal

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Abstract:Background: The Inner City Asthma Intervention (ICAI) was a national multi-center implementation of an evidence-based intervention to reduce asthma morbidity. Objective: This study describes mitigating behaviors and reported outcomes in families with asthma who completed the intervention and a post-intervention survey at one of the ICAI sites. Results: Eighty percent (0.72-0.88, 95% confidence interval) of these families made five or more changes to mitigate exposure to environmental asthma triggers. The majority of families (0.84-0.96, 95% confidence interval) reported an improved awareness of asthma symptoms and less school absences, limitations of activity, unplanned doctor visits, and asthma related sleep disruption. This research has been supported in part by a grant from the U.S. Environmental Protection Agency's Science to Achieve Results program (grant number R-8296650) and in part by the USDA grant MAS00870-0193776. This article has not been subjected to any EPA or USDA review and therefore does not necessarily reflect the views of either Agency, and no official endorsement should be inferred.Keywords: Asthma, health intervention, health behavior, family centered care, health outcomes 1 AbstractBackground: The Inner City Asthma Intervention (ICAI) was a national multi-center implementation of an evidence-based intervention to reduce asthma morbidity. Objective: This study describes mitigating behaviors and reported outcomes in families with asthma who completed the intervention and a post-intervention survey at one of the ICAI sites. Results: Eighty percent (0.72-0.88, 95% confidence interval) of these families made five or more changes to mitigate exposure to environmental asthma triggers. The majority of families (0.84-0.96, 95% confidence interval) reported an improved awareness of asthma symptoms and less school absences, limitations of activity, unplanned doctor visits, and asthma related sleep disruption.2

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A randomized clinical trial to reduce asthma morbidity among inner-city children: Results of the National Cooperative Inner-City Asthma Study

Cited by 325 publications

References 24 publications

Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

Asthma Management Survey of Participants in an Inner City Asthma Intervention

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