Assessing the value of disease management: Impact of 2 disease management strategies in an underserved asthma population

Autumn D Galbreath, Brad Smith, Pamela R Wood, Stephen Inscore, Emma Forkner, Marilu Vazquez, Andre Fallot, Robert Ellis, Jay I Peters

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: The goal of disease management (DM) is to improve health outcomes and reduce cost through decreasing health care utilization. Although some studies have shown that DM improves asthma outcomes, these interventions have not been examined in a large randomized controlled trial. Objective: To compare the effectiveness of 2 previously successful DM programs with that of traditional care. Methods: Nine hundred two individuals with asthma (429 adults; 473 children) were randomly assigned to telephonic DM, augmented DM (ADM; DM plus in-home visits by a respiratory therapist), or traditional care. Data were collected at enrollment and at 6 and 12 months. Primary outcomes were time to first asthma-related event, quality of life (QOL), and rates of asthma-related health care utilization. Secondary outcomes included rate of controller medication initiation, number of oral corticosteroid bursts, asthma symptom scores, and number of school days missed. Results: There were no significant differences between groups in time to first asthma-related event or health care utilization. Adult participants in the ADM group had greater improvement in QOL (P = .04) and a decrease in asthma symptoms (P = .001) compared with other groups. Of children not receiving controller medications at enrollment (13%), those in the intervention groups were more likely to have controller medications initiated than the control group (P = .01). Otherwise, there were no differences in outcomes. Conclusions: Overall, participation in asthma DM did not result in significant differences in utilization or clinical outcomes. The only significant impact was a higher rate of controller medication initiation in children and improvement in asthma symptoms and QOL in adults who received ADM.

Original languageEnglish (US)
Pages (from-to)599-607
Number of pages9
JournalAnnals of Allergy, Asthma and Immunology
Volume101
Issue number6
StatePublished - Dec 2008

Fingerprint

Vulnerable Populations
Disease Management
Asthma
Patient Acceptance of Health Care
Quality of Life
House Calls
Adrenal Cortex Hormones
Randomized Controlled Trials
Costs and Cost Analysis
Control Groups
Health

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Assessing the value of disease management : Impact of 2 disease management strategies in an underserved asthma population. / Galbreath, Autumn D; Smith, Brad; Wood, Pamela R; Inscore, Stephen; Forkner, Emma; Vazquez, Marilu; Fallot, Andre; Ellis, Robert; Peters, Jay I.

In: Annals of Allergy, Asthma and Immunology, Vol. 101, No. 6, 12.2008, p. 599-607.

Research output: Contribution to journalArticle

Galbreath, AD, Smith, B, Wood, PR, Inscore, S, Forkner, E, Vazquez, M, Fallot, A, Ellis, R & Peters, JI 2008, 'Assessing the value of disease management: Impact of 2 disease management strategies in an underserved asthma population', Annals of Allergy, Asthma and Immunology, vol. 101, no. 6, pp. 599-607.
Galbreath, Autumn D ; Smith, Brad ; Wood, Pamela R ; Inscore, Stephen ; Forkner, Emma ; Vazquez, Marilu ; Fallot, Andre ; Ellis, Robert ; Peters, Jay I. / Assessing the value of disease management : Impact of 2 disease management strategies in an underserved asthma population. In: Annals of Allergy, Asthma and Immunology. 2008 ; Vol. 101, No. 6. pp. 599-607.
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