• J Asthma · Apr 2019

    Multicenter Study

    Enhancing guideline-based asthma care processes through a multi-state, multi-center quality improvement program.

    • Sirikan Rojanasarot, Jill Heins Nesvold, Pinar Karaca-Mandic, Wendy L St Peter, Julian Wolfson, Jon C Schommer, and Angeline M Carlson.
    • a Department of Pharmaceutical Care & Health Systems, College of Pharmacy , University of Minnesota , Minneapolis , Minnesota , USA.
    • J Asthma. 2019 Apr 1; 56 (4): 440-450.

    ObjectiveThis study investigated the effectiveness of Enhancing Care for Patients with Asthma (ECPA)-a collaborative quality improvement program implemented in 65 community health centers that serve asthma patients in four states-on clinic-based asthma performance measures consistent with national guidelines.MethodsThis study utilized a pretest-posttest quasi-experimental design. Six clinic-based performance measures of each center were collected from a retrospective chart review at time points: before the ECPA implementation; at the end of the 12-month long ECPA program; and 6 months after program completion. The effectiveness of the ECPA was assessed using generalized linear mixed models with a Poisson distribution and log link by evaluating the change in each measure from baseline to program completion, from baseline to 6-month post-program completion and from program completion to 6-month post-program completion.ResultsThe ECPA implementation was positively associated with improvement in all measures from baseline to program completion: documentation of asthma severity (rate ratio (RR) 1.314; 95% confidence interval (CI) 1.206, 1.432); Asthma Control Test (RR 3.625; 95% CI 3.185, 4.124); pulmonary function testing (RR 1.771; 95% CI 1.527, 2.054), asthma education (RR 2.246; 95% CI 2.018, 2.501), asthma action plan (RR 2.335; 95% CI 2.070, 2.634) and controller medication (RR 1.961; 95% CI 1.504,2.556). Improvement was sustained for all six measures at the 6-month post-program completion time point.ConclusionThis study demonstrated the favorable effect of the ECPA program on evidence-based asthma quality measures. This program could be considered a model worth replication on a broader scale.

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