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Improvements in Asthma Pharmacotherapy and Self-Management: An Example of a Population-Based Disease Management Program

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Author Info

  • Richard A. Feifer

    (Medco Health Solutions Inc., Franklin Lakes, New Jersey, USA)

  • Robert R. Verbrugge

    (Medco Health Solutions Inc., Franklin Lakes, New Jersey, USA)

  • Mona Khalid

    (Medco Health Solutions Inc., Franklin Lakes, New Jersey, USA)

  • Rebecca Levin

    (Medco Health Solutions Inc., Franklin Lakes, New Jersey, USA)

  • Gwendolyn B. OKeefe

    (Medco Health Solutions Inc., Franklin Lakes, New Jersey, USA)

  • Ronald E. Aubert

    (Medco Health Solutions Inc., Franklin Lakes, New Jersey, USA)

Registered author(s):

    Abstract

    Background and objective: In day-to-day practice, asthma treatment and self-management often fall short of the objectives defined by clinical practice guidelines. The objective of this study was to determine whether a population-based asthma disease management program, using broad-based educational interventions, can have a favorable impact on physician and patient adherence to guidelines-based care. Methods: A longitudinal, before-and-after design was used to evaluate program impacts on pharmacotherapy and health status. Patients with asthma (n = 35 Main outcome measures and results: The percentage of patients who started controller therapy during the study period was significantly higher for the intervention group than the control group (20.7% versus 18.1%, p < 0.001). The controller prescription fill rate increased significantly in the intervention group compared with controls (p < 0.0001); the increase was primarily driven by increased refill rates for patients already using controllers. Reliever prescription fill rates decreased for both the intervention group and controls. Program participants reported significant improvements in asthma-related QOL (p < 0.05) and self-management skills. Self-reported medical utilization decreased for office visits (p < 0.05) and emergency room visits (p < 0.01). Conclusions: A population-based asthma disease management program can improve controller prescribing rates (new therapy starts), controller adherence rates (refill persistency), and self-management skills. These changes in physician and patient behavior help close the gaps between guidelines and practice in asthma therapy.

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    Bibliographic Info

    Article provided by Wolters Kluwer Health | Adis in its journal Disease Management & Health Outcomes.

    Volume (Year): 12 (2004)
    Issue (Month): 2 ()
    Pages: 93-102
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:dmhout:v:12:y:2004:i:2:p:93-102

    Contact details of provider:
    Web page: http://diseasemanagement.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Asthma; Disease-management-programmes; Self-medication;

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