Comprehensive long-term management program for asthma

Effect on outcomes in adult African-Americans

Tiffany M. Kelso, Nabil Abou-Shala, Greta M. Heilker, Kristopher Arheart, Tracy S. Portner, Timothy H. Self

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

To determine if a comprehensive long-term management program, emphasizing inhaled corticosteroids and patient education, would improve outcomes in adult African-American asthmatics a nonrandomized control trial with a 2- year intervention was performed in a university-based clinic. Inclusion criteria consisted of (≥5) emergency department (ED) visits or hospitalizations (≥2) during the previous 2 years. Intervention patients were volunteers; a comparable control group was identified via chart review at hospitals within the same area and time period as the intervention patients. Individualized doses of beclomethasone with a spacer, inhaled albuterol 'as needed,' and crisis prednisone were the primary therapies. Environmental control, peak flow monitoring, and a partnership with the patient were emphasized. Detailed patient education was an integral part of management. Control patients received usual care from local physicians. ED visits and hospitalizations for 2 years before and 2 years during the intervention period were compared. Quality of life (QOL) measurements were made at baseline and every 6 months in the intervention group. Study group (n = 21) had a significant reduction in ED visits (2.3 ± 0.2 pre-intervention versus 0.6 ± 0.2 post-intervention; P = 0.0001). Control group (n = 18) did not have a significant change in ED visits during the 2-year post- intervention period (2.6 ± 0.2 pre-intervention versus 2.0 ± 0.2 post- intervention; P = 0.11). Both groups had significant reductions in hospitalizations, but the study group had a greater reduction. Sixty-two percent of study patients had complete elimination of ED visits and hospitalizations, whereas no control patients had total elimination of the need for institutional acute care. QOL in the study patients revealed significant improvements for most parameters. A comprehensive long-term management program emphasizing inhaled corticosteroids combined with other state-of-the-art management, including intensive patient education, improves outcomes in adult African-American asthmatics.

Original languageEnglish
Pages (from-to)272-280
Number of pages9
JournalAmerican Journal of the Medical Sciences
Volume311
Issue number6
DOIs
StatePublished - Jun 1 1996
Externally publishedYes

Fingerprint

African Americans
Asthma
Hospital Emergency Service
Patient Education
Hospitalization
Adrenal Cortex Hormones
Hospitalization Insurance
Quality of Life
Beclomethasone
Control Groups
Albuterol
Prednisone
Volunteers
Physicians

Keywords

  • Asthma
  • Inhaled corticosteroids
  • Minorities
  • Outcomes
  • Patient education

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Comprehensive long-term management program for asthma : Effect on outcomes in adult African-Americans. / Kelso, Tiffany M.; Abou-Shala, Nabil; Heilker, Greta M.; Arheart, Kristopher; Portner, Tracy S.; Self, Timothy H.

In: American Journal of the Medical Sciences, Vol. 311, No. 6, 01.06.1996, p. 272-280.

Research output: Contribution to journalArticle

Kelso, Tiffany M. ; Abou-Shala, Nabil ; Heilker, Greta M. ; Arheart, Kristopher ; Portner, Tracy S. ; Self, Timothy H. / Comprehensive long-term management program for asthma : Effect on outcomes in adult African-Americans. In: American Journal of the Medical Sciences. 1996 ; Vol. 311, No. 6. pp. 272-280.
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