Evaluation of a Program Aimed at Increasing Referrals for Asthma Education of Patients Consulting at the Emergency Department for Acute Asthma

Robichaud, Patricia; Laberge, A; Allen, Marie-France; Boutin, Hélène; Rossi, Catherine; Lajoie, Pierre; Boulet, Louis‐Philippe

doi:10.1378/chest.126.5.1495

Cited by 28 publications

(20 citation statements)

References 15 publications

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“…Indeed, of the more than 300 physicians in current practice to whom the advertisement describing the AEC's activities was sent, only a small number referred patients, regardless of the services offered. This is in keeping with recent surveys showing persistent care gaps in asthma management (8)(9)(10)16).…”

Section: Discussionsupporting

confidence: 90%

“…This would have been the case had a patient been given a referral and forgotten to contact the AEC regarding this matter. A previous study by Robichaud et al (16) Impact of access to spirometry in asthma education centres showed that even in an optimum situation in which the patient is directly referred to the AEC and is then contacted by the educator, only approximately 50% will end up receiving education. In that study, 1104 patients were referred to an AEC directly by fax from the emergency room; 106 patients (15%) could not be contacted, 114 patients (16.1%) refused the intervention, 488 patients (68.9%) made appointments and 346 patients (48.9%, or 72.8% of scheduled patients) honoured their appointments.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, only a small proportion of asthmatic patients consulting for acute asthma are directed to AECs. Strategies to increase the number of patients referred to these centres have been developed, such as automatic referrals to AECs from emergency departments and various initiatives to support guideline implementation by primary care physicians (16). We herein describe a strategy aimed at offering easy access to spirometry in AECs to determine its impact on the referral rate of asthma patients to AECs.…”

mentioning

confidence: 99%

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Can Access to Spirometry in Asthma Education Centres Influence the Referral Rate by Primary Physicians for Education?

Labrecque

Lavallee²,

Beauchesne³

et al. 2006

Canadian Respiratory Journal

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M Labrecque, M Lavallée, MF Beauchesne, A Cartier, LP Boulet. Can access to spirometry in asthma education centres influence the referral rate by primary physicians for education? Can Respir J 2006;13(8):427-431.BACKGROUND AND OBJECTIVES: Asthma remains uncontrolled in a large number of asthmatic patients. Recent surveys have shown that a minority of asthmatic patients are referred to asthma educators.The objective of the present study was to assess the influence of increased access to spirometry in asthma education centres (AECs) on the rate of patient referrals to these centres by general practitioners. METHODS: A one-year, prospective, randomized, multicentric, parallel group study was conducted over two consecutive periods of six months each, with added spirometry being offered in the second sixmonth period to the experimental group. Ten AECs were enrolled in the project. An advertisement describing the AECs' services was sent by mail to a total of 303 general practitioners at the start of each period, inviting them to refer their patients. Measures of the frequency of medical referrals to the AECs were assessed for each period. RESULTS: The group of AECs randomly selected for spirometry in the second six-month period received 48 medical referrals during the first period and 32 during the second one, following proposed spirometry. AECs that had not offered spirometry received five referrals during the first period and seven during the second period. One AEC withdrew a few weeks after the study began and others encountered administrative problems, reducing their ability to provide interventions. CONCLUSIONS: Referral to AECs is not yet integrated into the primary care of asthma and offering more rapid access to spirometry in the AECs does not seem to be a significant incentive for such referrals.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Can Access to Spirometry in Asthma Education Centres Influence the Referral Rate by Primary Physicians for Education?

Labrecque

Lavallee²,

Beauchesne³

et al. 2006

Canadian Respiratory Journal

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“…(2) To this scenario, we can add the lack of access to inhaled corticosteroids for this population, (3) the inefficiency of the health care system and of the professionals in providing accessible information about asthma, (4) the lack of efficient educational measures to increase patient awareness of asthma, (3) and inappropriate asthma management by health professionals.…”

Section: Introductionmentioning

confidence: 99%

Redução do número de internações hospitalares por asma após a implantação de programa multiprofissional de controle da asma na cidade de Londrina

Neto¹,

Filho

Bueno³

et al. 2008

J. bras. pneumol.

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Objective: To evaluate the relationship between the reduction in the number of asthma-related hospital admissions and the changes occurring after the intervention performed in the health care system of the city of Londrina, Brazil. Methods: In 2003, an intervention was performed in the local health care system (Family Health Clinics) The steps adopted were as follows: development of a protocol based on the III Brazilian Consensus on Asthma Management; access to free inhaled corticosteroids for patients; training of health professionals; and implementation of educational measures, especially for the community. The authorizations for hospital admission of patients diagnosed with asthma alone between 2002 and 2005 in the city of Londrina were analyzed. Results: The mean age was 14.3 ± 0.5 years, without gender predominance. The number of hospital admissions fell more markedly in 2005 than in the previous years studied. This decline was more pronounced at the Family Health Clinics where professional training occurred earlier. The post-intervention (2004The post-intervention ( -2005 rate of asthma-related hospital admissions (120/100,000 inhabitants) was significantly lower than the pre-intervention (2002)(2003) rate (178/100,000 inhabitants; p < 0.01). Conclusions: The admission curve showed a tendency toward a reduction after 2003, and, aside from the intervention performed, no other factors that would explain the results obtained were identified. The rate at which the number of hospital admissions decreased was in direct proportion to the length of time elapsed since the intervention (greater decreases over time). We conclude that the intervention performed in the local health care system was responsible for the data presented.

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“…In one of our recent reports, offering educational services through an experienced educator who attended family medicine clinics resulted in a significant reduction in unscheduled physician visits and more appropriate medication use, as well as increased provision of an action plan [25]. Furthermore, an emergency department-based "automatic" referral programme to an asthma educator resulted in improved assessment of asthma control and a marked increase in such referral [18].…”

mentioning

confidence: 99%

Asthma education: an essential component in asthma management

Boulet

2015

Eur Respir J

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Evaluation of a Program Aimed at Increasing Referrals for Asthma Education of Patients Consulting at the Emergency Department for Acute Asthma

Cited by 28 publications

References 15 publications

Can Access to Spirometry in Asthma Education Centres Influence the Referral Rate by Primary Physicians for Education?

Can Access to Spirometry in Asthma Education Centres Influence the Referral Rate by Primary Physicians for Education?

Redução do número de internações hospitalares por asma após a implantação de programa multiprofissional de controle da asma na cidade de Londrina

Asthma education: an essential component in asthma management

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