Case Management and Quality Assurance to Improve Care of Inner-city Children With Asthma

Wissow, Lawrence S.; Warshow, M.; Box, Jean; Baker, Douglas

doi:10.1001/archpedi.1988.02150070062026

Cited by 21 publications

(11 citation statements)

References 16 publications

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“…A child was considered to have asthma if the parent stated a physician had made the diagnosis. Exclusion criteria were (1) admission to hospital at the time of the ED visit, (2) chronic illness other than asthma, (3) no working telephone in home, (4) participation of this child or another child in the same household in this or another asthma study, (5) no primary care provider, and (6) inability to communicate effectively in English. The details of the recruitment process have been published.…”

mentioning

confidence: 99%

Improving follow-up for children with asthma after an acute Emergency Department visit

Smith¹,

Jaffe²,

Fisher³

et al. 2004

The Journal of Pediatrics

130

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mentioning

confidence: 99%

Improving follow-up for children with asthma after an acute Emergency Department visit

Smith¹,

Jaffe²,

Fisher³

et al. 2004

The Journal of Pediatrics

130

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“…Families move frequently (29% moved at least once during a 1-year observation) (Swartz et al 2004), so the address and telephone numbers in a database may not be current. Additionally, as many as 25% of inner-city families may not have telephones (Wissow et al 1988), and 52% may change their telephone number at least once during a year of follow-up (Swartz et al 2004). This not only makes initial contact difficult but also interferes with follow-up.…”

Section: Barriers To Recruitmentmentioning

confidence: 99%

Lessons Learned for the Study of Childhood Asthma from the Centers for Children’s Environmental Health and Disease Prevention Research

Eggleston

Diette

Lipsett

et al. 2005

Environ Health Perspect

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The National Children’s Study will address, among other illnesses, the environmental causes of both incident asthma and exacerbations of asthma in children. Seven of the Centers for Children’s Environmental Health and Disease Prevention Research (Children’s Centers), funded by the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency, conducted studies relating to asthma. The design of these studies was diverse and included cohorts, longitudinal studies of older children, and intervention trials involving asthmatic children. In addition to the general lessons provided regarding the conduct of clinical studies in both urban and rural populations, these studies provide important lessons regarding the successful conduct of community research addressing asthma. They demonstrate that it is necessary and feasible to conduct repeated evaluation of environmental exposures in the home to address environmental exposures relevant to asthma. The time and staff required were usually underestimated by the investigators, but through resourceful efforts, the studies were completed with a remarkably high completion rate. The definition of asthma and assessment of disease severity proved to be complex and required a combination of questionnaires, pulmonary function tests, and biologic samples for markers of immune response and disease activity. The definition of asthma was particularly problematic in younger children, who may exhibit typical asthma symptoms sporadically with respiratory infections without developing chronic asthma. Medications confounded the definition of asthma disease activity, and must be repeatedly and systematically estimated. Despite these many challenges, the Children’s Centers successfully conducted long-term studies of asthma.

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“…A tendência de utilização de serviços de emergência, como único contato do paciente com o tratamento de asma brônquica, está relacionada não só ao fator sócio-econômico e às dificuldades de acesso aos serviços ambulatoriais, como também ao desconhecimento por parte de algumas famílias da necessidade do cuidado contínuo do paciente asmático (Mak et al, 1982;Wissow et al, 1988;Halfon & Newacheck, 1993).…”

Section: Atenção à Criança Asmáticaunclassified

Avaliação do programa de atenção a crianças asmáticas acompanhadas nas unidades de saúde do Município do Embu, São Paulo, no período de 1988 a 1993

et al. 1998

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Com o objetivo de avaliar o desempenho do Programa de Atenção a Crianças Portadoras de "Chiado no Peito", no Município de Embu, São Paulo, foram estudadas 434 crianças e adolescentes de zero a 14 anos, admitidas no programa de maio/88 a julho/93. Mais de 90% desses pacientes nunca haviam sido acompanhados por esse motivo em serviço médico. Apenas 6,2% foram encaminhados a outros serviços de referência durante o acompanhamento no programa. Segundo critérios clínicos, os pacientes foram classificados em: bebê chiador (21,8%), asmáticos leves (41,7%), asmáticos moderados (28,3%), asmáticos graves (7,6%) e outros (0,4%). Ao se analisar o comportamento dos asmáticos moderados e graves acompanhados por mais de um ano, observou-se melhora clínica nesses dois grupos, e o que influenciou positivamente esse fato foi a maior aderência ao uso da medicação. O número de exacerbações decresceu entre os asmáticos graves, após um ano de acompanhamento regular, embora durante os 12 meses analisados tenha havido um consumo praticamente constante de medicação broncodilatadora. O abandono ocorreu em 53,2% das crianças matriculadas, principalmente nos primeiros seis meses de acompanhamento, sendo significantemente mais freqüente entre os asmáticos moderados. Concluímos que as crianças com maior aderência ao programa se beneficiaram do mesmo, apesar das dificuldades e da falta de alguns recursos medicamentosos atualmente existentes.

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Case Management and Quality Assurance to Improve Care of Inner-city Children With Asthma

Cited by 21 publications

References 16 publications

Improving follow-up for children with asthma after an acute Emergency Department visit

Improving follow-up for children with asthma after an acute Emergency Department visit

Lessons Learned for the Study of Childhood Asthma from the Centers for Children’s Environmental Health and Disease Prevention Research

Avaliação do programa de atenção a crianças asmáticas acompanhadas nas unidades de saúde do Município do Embu, São Paulo, no período de 1988 a 1993

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