A set of comprehensive asthma management tools helps decrease asthma-related visits to the emergency department, urgent care or hospital and improves patients' asthma control. The Asthma APGAR tools, including an asthma control assessment completed by patients and linked to an asthma management algorithm, were tested in a randomized controlled study of 18 family medicine and pediatric practices across the United States. The study compared outcomes in more than 1,000 patients with persistent asthma aged five to 45 years using Asthma APGAR tools versus usual care. The proportion of patients reporting an asthma-related emergency department, urgent care or hospital visit in the final six months of the study differed significantly between groups: 11 percent for intervention groups and 21 percent for usual care groups. Between baseline and one year, the percentage of patients whose asthma was in control increased significantly in the intervention group (14 percent) compared to the usual care group (3 percent), with a trend toward better control scores and asthma-related quality of life in the intervention group at 12 months. Intervention practices also significantly increased their adherence to three or more elements of the National Asthma Education and Prevention Program guidelines compared to usual care practices. Participating practices reported that changing practice to incorporate the Asthma APGAR tools was challenging, but the tools themselves were perceived as useful and efficient. The authors suggest that the Asthma APGAR tools are effective for asthma management in the primary care practice setting.
Use of Asthma APGAR Tools in Primary Care Practices: A Cluster-Randomized, Controlled Trial
Barbara P. Yawn, MD MSc FAAFP, et al
Olmsted Medical Center, Rochester, Minnesota