The Journal of asthma : official journal of the Association for the Care of Asthma
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This prospective study was designed to determine whether incorporating formoterol into a standardized respiratory therapist-directed protocol for administering bronchodilators to hospitalized patients with obstructive airway disease would reduce health care resource use and provide a safety advantage. All patients admitted to Washington Hospital Center with asthma and chronic obstructive pulmonary disease (CODP) are administered bronchodilators under a standardized respiratory therapist-directed protocol. Formoterol was the primary bronchodilator for the intervention period from January through March 2002, with levalbuterol, albuterol, and ipratropium available as needed. ⋯ Bronchodilator treatments per admission, respiratory therapist visits per admission, and time spent per admission, and cost per bronchodilator treatment significantly decreased in 2002. Significantly fewer adverse events related to bronchodilator treatments were reported in 2002 than 2000. The addition of formoterol to a respiratory therapist-directed protocol for administering bronchodilators reduced health care resource use and adverse events for patients with asthma and COPD.
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Asthma is the most common chronic illness in childhood. Recruiting children and their parents into a research study in a busy urban emergency department (ED) is challenging. The purpose of this manuscript is to describe the recruitment process and the results of our recruitment in soliciting children and their parents to participate in an ED-based asthma research study. ⋯ Recruiting subjects into long-term follow-up studies in the ED setting is a departure from traditional ED studies. The ED enrollment offers the distinct advantage of capturing subjects who are unlikely to present for care in other locations. We were able to successfully recruit low-income urban parents of children with asthma for study of both short-term and long-term outcomes. Careful attention to planning and then integration of enrollers into the ED setting can result in successful recruitment of patients and their parents. The enrollment process successfully captured the subjects of interest without bias.
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Asthma is the most common chronic childhood illness and the leading cause of missed school days. School is a potential location for establishing an asthma education program for children and their parents/caregivers designed to improve disease management. ⋯ A comprehensive, school-based asthma management program can successfully improve asthma control and reduce absenteeism in elementary and middle school students and caregiver lost workdays.
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Randomized Controlled Trial Clinical Trial
Effects of a self-management asthma educational program in Taiwan based on PRECEDE-PROCEED model for parents with asthmatic children.
This study was conducted to evaluate the comparative effectiveness of two different asthma educational programs. One was self-management asthma education based on the PRECEDE-PROCEED model to change the influential factors based on a previous need assessment study in Taiwan. The other consisted of regular outpatient asthma education. ⋯ The trend indicated that educational effects were sustained for at least 3 months, with some for 6 months. In order to maintain the educational effects, further specific series of educational programs can be designed based on the patterns of self-management behavior stages every 6 months. The effects of health outcomes may show significant differences using longer follow-up times in future clinical trials.
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Allergic rhinitis and asthma each require costly medical resource utilization, and the impact of both conditions is believed to be even greater. This retrospective cost of illness study evaluated the impact of allergic rhinitis on asthma medical care resource utilization rates and costs for patients with asthma plus allergic rhinitis vs. patients with asthma alone. Patients with one or more claims for asthma (n=27,398) were identified from a medical claims database from a large, northeastern U. ⋯ Allergic rhinitis in patients with asthma nearly doubles annual medical resource utilization and costs and is associated with increased utilization of asthma-related medications. Based on use of asthma medications, patients with concomitant allergic rhinitis can be regarded as having more severe asthma than do those without allergic rhinitis. Physicians should assess asthma patients for symptoms of allergic rhinitis to improve asthma treatment.