The Science Journal of the American Association for Respiratory Care
Problem statement: National Asthma Education and Prevention (NAEP) guidelines state that quality of life can be improved for asthma patients with increased use of peak flowmeters and written asthma plans. Can respiratory care practitioners (RCPs) increase the number of written asthma plans and peak flowmeters among moderate and severe asthma patients?
Program description: Hawaii may have the highest asthma prevalence and mortality in the Nation. The windward side of Oahu has the highest asthma prevalence on the Island of Oahu and the largest number of asthma patients in Hawaii. Castle Medical Center, 120 beds, is the primary medical center for Windward Oahu, approximately 500-700 asthma cases are seen each year. In 1997 a comprehensive asthma program based on NAEP guidelines was implemented.
Methods: The Emergency Department (E.D.) was remodeled to optimize treatment of asthma. E.D. physicians, nurses and RCPs received training in asthma treatment according to NAEP Guidelines. Protocols for asthma treatment, education and data collection were implemented. Soon after E.D. discharge RCPs contact each asthma patient by telephone. The patient's primary physician is asked to order an Asthma Assessment and Education Session (AAES) by an RCP. Sixty-eight asthma patients received AAES.
Results: Major findings include 2.36 times increase in use of peak flowmeters, 4.47 times increase in use of written asthma management plans and increased use of anti-inflammatory medications.
Discussion: These data demonstrate that intervention by respiratory care practitioners can improve self-management of asthma. In turn this improved asthma management may reduce asthma morbidity.