Managing Asthma as a Team

Children with asthma had fewer return hospital visits with team care

(RxWiki News) As with so many other things in life, teamwork can lead to better outcomes in medical care. This can be especially true with chronic conditions.

A recent study found that following specific protocols in managing children's asthma led to better results for the kids.

Ensuring the children had follow-up appointments and used a "medical home," or team-based delivery plan, led to fewer return visits to the hospital.

The results imply that following these protocols and providing a medical home to children with asthma could lead to better management of the condition.

"Discuss long-term asthma management with your pediatrician."

The study, led by Lora Bergert, MD, of the Department of Pediatrics at the University of Hawaii John A. Burns School of Medicine, aimed to find better ways to manage asthma in children.

The authors tested how well the measures of the Children's Asthma Care protocol were followed among children aged 2 to 18.

Children's Asthma Care (CAC) involves three requirements: use of a bronchodilator/reliever medication, systemic corticosteroid use and completion of a home management plan of care (which requires a follow-up appointment).

A total of 532 children involved in the study had been hospitalized due to an asthma attack between January 2008 and June 2012.

Then these children's follow-up appointments were tracked each month after discharge to see if the children were hospitalized again or returned to the ER.

These rates were compared to the rates among 231 children and teens during the two years before the CAC protocol was implemented at the hospital.

The researchers found that the hospital was compliant in meeting the third CAC requirement (plan of care) with 95 percent of all the patients between October 2009 and June 2012.

In 2009 between January and September, 69 percent of the patients had their post-discharge follow-up appointment, but this increased to 90 percent of the patients between October 2009 and June 2012.

Meanwhile, rates of being readmitted to the hospital in the three to six months after the first visit dropped by 70 percent.

The researchers concluded that following the protocol for CAC resulted in fewer children needing to be admitted to the hospital again.

"This finding supports the notion that a smooth transition from the inpatient setting to the patient-centered medical home leads to an improvement in outcomes," the authors wrote.

A "medical home" is a centralized health care delivery plan in which a team of doctors manages a patient's care together.

"We attribute our results to the efforts of a multidisciplinary Asthma Task Force in providing comprehensive medical care for children hospitalized with asthma," the authors wrote.

The study was published June 16 in the journal Pediatrics. The research did not use external funding, and the authors reported no conflicts of interest.

Review Date: 
June 15, 2014