Managed Care and the Treatment of Asthma

OʼBrien, Kevin P.

doi:10.3109/02770909509082757

Cited by 20 publications

(1 citation statement)

References 28 publications

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“…Although not a formal review, a further paper described 10 US-based managed care programmes for asthma. 117 Both papers gave recommendations for key components of these multifaceted interventions and presented data to suggest that they improve outcomes, but the results and quality of studies were not formally used to draw conclusions regarding effectiveness.…”

Section: Multifaceted and Related Interventions For Asthmamentioning

confidence: 99%

A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma

Smith

Mugford

Holland

et al. 2005

Health Technol Assess

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Section: Multifaceted and Related Interventions For Asthmamentioning

confidence: 99%

A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma

Smith

Mugford

Holland

et al. 2005

Health Technol Assess

View full text Add to dashboard Cite

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Medications prescribed to asthmatic children: an historical cohort study comparing clinical practice with NIH recommendations

Ward

Willey

ScD

2000

Pharmacoepidem. Drug Safe.

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Purpose — NIH guidelines recommend maintenance treatment of persistent moderate or severe childhood asthma with preventive anti‐inflammatory medication (inhaled corticosteroids, cromolyn or nedocromil). The objective was to determine if the NIH guidelines for the treatment of childhood asthma were implemented by examining the prevalence of prescribing preventive medication. Methods — This was a non‐concurrent cohort study of 311 children (aged 2 to 19 years) who were treated for asthma between January and December 1994 by nine Medicaid managed care plans in the northeastern USA. Results — Preventive medications were prescribed at least once to 61.1% of the children with moderate or severe asthma and to 27.1% of the children with mild asthma. Logistic regression analyses indicated prescribing preventive medication was associated with moderate or severe asthma (aOR 5.34, 95% CI 3.22 – 8.83) and age 5 to 19 years (aOR 2.11, 95% CI 1.19 – 3.72). Prescribing preventive medication was also associated with a prior emergency department visit (aOR 2.27, 95% CI 1.24 – 4.16), after adjusting for age. Conclusions — Prescribing preventive medications is related to sentinel clinical events and the NIH recommendations are not routinely implemented for all children with moderate or severe asthma during this study period. Copyright © 2000 John Wiley & Sons, Ltd.

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Cost effectiveness of guideline advice for children with asthma: A literature review

Feenstra

Mölken

Jager

et al. 2002

Pediatric Pulmonology

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Asthma is an important chronic disease among children. This study reviews the cost effectiveness of interventions in the long-term care of asthmatic children and compares these results with treatment advice in four current guidelines. Cost-effectiveness studies were searched for in Medline, Embase, Healthstar, Biosis, and the Office of Health Economics-Health Economic Evaluations Database (OHE-HEED), and the Cochrane Library was searched for meta-analyses of clinical trials. In the four reviewed guidelines, cost effectiveness is not explicitly used as a criterion. The cost-effectiveness studies show sufficient evidence for the cost effectiveness of treatment with inhaled steroids and for self-management programs for severe asthmatic patients. Inclusion of these results in the guidelines would not lead to significant changes in current treatment advice. The effectiveness of various measures for trigger avoidance is not fully proven, and hence neither is their cost effectiveness. Available information on the cost effectiveness of cromolyn could be used to focus the guidelines. Finally, evidence exists that organizational interventions, e.g., the employment of asthma nurses, can result in cost savings, but it is unclear to what extent these results can be generalized. More cost-effectiveness studies are needed, especially on long-acting bronchodilators and self-management programs for mild and moderate asthma, in order to help make the guidelines more informative and reduce the differences between them.

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Managed Care and the Treatment of Asthma

Cited by 20 publications

References 28 publications

A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma

A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma

Medications prescribed to asthmatic children: an historical cohort study comparing clinical practice with NIH recommendations

Cost effectiveness of guideline advice for children with asthma: A literature review

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