• Don D Sin, Neil R Bell, and S F Paul Man.
• James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, Department of Medicine (Pulmonary Division), University of British Columbia, Vancouver, Canada. dsin@mrl.ubc.ca
• Am. J. Med. 2004 Oct 1; 117 (7): 479-83.

PurposeMany asthmatic patients discharged from emergency departments do not have timely follow-up visits with a primary care physician. This study was conducted to determine the effectiveness of a health professional-based intervention in improving process of care and health outcomes among asthmatic patients discharged from emergency departments.MethodsWe enrolled 125 asthmatic patients, aged 5 through 50 years, from the emergency department of a community-based hospital; 62 patients were assigned to usual care and 63 to enhanced care. Enhanced care consisted of usual care plus employment of a coordinator to make follow-up appointments with the patient's primary care physician with at least one reminder telephone call to the patient.ResultsAt 6 months of follow-up, mean (+/- SD) asthma and pediatric quality-of-life scores were higher in the enhanced care group than in the usual care group (5.7 +/- 1.2 units vs. 5.0 +/- 1.3 units, P = 0.01). The enhanced care group also had a higher rate of follow-up office visits (78% [n = 44] vs. 60% [n = 33], P = 0.003), were more likely to have written action plans (46% [n = 26] vs. 25% [n = 14], P = 0.02), and had fewer asthma symptoms (1.8 +/- 1.1 units vs. 2.2 +/- 1.3 units, P = 0.09). However, these differences disappeared by 12 months of follow-up.ConclusionA simple intervention wherein a health professional facilitates follow-up visits can improve the process of care and health outcomes of high-risk asthmatic patients. However, the effect of this intervention is time limited and largely wears off by 12 months.

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