The Journal of asthma : official journal of the Association for the Care of Asthma
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Randomized Controlled Trial
A randomized, controlled study to evaluate the role of an in-home asthma disease management program provided by respiratory therapists in improving outcomes and reducing the cost of care.
Asthma management programs (AMP) may reduce costs and improve outcomes in patients with moderate to severe asthma. However, it is not known which personnel are best able to deliver such interventions and what settings are most effective. The purpose of this study was to compare the effects of an in-home AMP provided by respiratory therapists (RTs) to an AMP provided by nurses (RNs) and to usual care (UC) provided in physician offices or clinics. ⋯ An in-home asthma management program can be effectively delivered by respiratory therapists and may reduce hospitalizations, in-patient days, cost and improve measures of HRQOL and PS in a population prone to asthma exacerbation.
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A number of educational programs have focused on promoting the knowledge of asthma to health care professionals, but not teaching competency. Increasing the cognition of self-efficacy on patient teaching could enhance the competency in teaching for patients with asthma. However, at present we do not have an appropriate tool to measure self-efficacy on asthma teaching for health care providers. ⋯ The first version of SEATs has an acceptable psychometric property to evaluate the asthma teaching efficacy of nurses, although three items were INFIT according to Rasch analysis. A different population of nurses should be recruited to further refine this tool. SEATs could be used as an outcome measure for further program evaluation.
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Clinical Trial
Influence of ambulatory inhaled treatment with different devices on the duration of acute asthma findings in children.
Efficacy of bronchodilator treatment in children with asthma depends on the proper use of inhalation devices. The aim of this study was to compare the efficacy of inhaled bronchodilator treatment with a spacer and a nebulizer in children with acute asthma findings. ⋯ Nebulizers and spacers have similar influence on the duration of acute asthma findings in children when used in ambulatory home bronchodilator treatment.
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Spirometry is the gold standard for assessment of asthma and is objective and non-invasive. This is a pilot study to evaluate whether portable spirometry can be successfully performed by children in the pediatric emergency department for acute exacerbations of asthma. ⋯ Portable spirometry can be successfully performed by children with acute exacerbations of asthma in the emergency department and demonstrated greater degrees of airway obstruction than did clinical signs. Spirometry provides objective, non-invasive measurements of the severity of airway obstruction in the emergency department for children with acute exacerbations of asthma.
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Several international asthma guidelines emphasize the importance of assessing asthma control. However, there is limited data on the usefulness of available assessment tools in indicating disease control in young asthmatics. This study investigated the ability of Chinese version of Childhood Asthma Control Test (C-ACT) and other disease-related factors in identifying uncontrolled asthma (UA) in young children. ⋯ C-ACT is better than objective parameters in identifying young Chinese children with UA.