1998 OPEN FORUM Abstracts
THE IMPACT OF ADULT ASTHMA EDUCATION IN THE EMERGENCY DEPARTMENT SETTING
Theresa Berquist BS RRT, Gerald Christopherson BS RRT, Tracy Christopherson RRT, Todd Smith BS RRT ; Butterworth Hospital, Grand Rapids, MI
BACKGROUND: If a patient lacks basic knowledge about asthma, their treatment regimen will likely fail because the patient is unaware of appropriate disease management steps. A survey of asthmatic patients in our emergency department (ED) found that 42% received the majority of their medical care in the ED. The purpose of this investigation was to determine if an asthma education program administered to asthmatic patients in the ED would improve self management of their asthma. Improvement was defined as a reduction in the number of ED visits, hospital admissions, and days of school or work missed due to asthma.
METHOD: 168 asthma patients >= 13 years of age who were seen and evaluated in the emergency department from March 1996 to December 1997 consented to be placed into the study. All subjects and a primary ED diagnosis of asthma and inhaled bronchodilators were administered. A questionnaire was administered to each eligible patient by a respiratory therapist. The questionnaire assisted the therapist in identifying the patients knowledge level related to asthma and its management, as well as the patients health care systems utilization pattern for the past four months. Following assessment and treatment the education program was started. Education included written materials and viewing a video containing information on asthma triggers, physiologic changes, medications, peak expiratory flow monitoring, MDI technique with spacer, and cleaning of equipment. The respiratory therapist reviewed with the patient all of the information provided. Patients also had to demonstrate the use of MDIs using a placebo inhaler. All subjects received follow up telephone interviews at two and four months after entry into the study. Results: Of the 168 subjects entered into the study, 109 completed the four month follow up questionnaire. The number of ED visits in the four months following education compared to the four months before education was significantly lower (mean 1.62 before to .47 after, paired t = 5.26 p = < .001). Work or school days missed due to asthma was also significantly lower after education when compared to before education (mean 3.16 before to 1.48 after, paired t = 2.15 p = .034). The number of hospital admissions was lower but not significantly (mean .23 before to .14 after, paired t = 2.15 p = 1.32). Conclusions: Asthma education administered within the emergency department does improve the self management of asthma resulting in fewer emergency room visits and missed school or work days.
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.