This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (33)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Patient Education/ Health Literacy  • Asthma  • Allergy  • Alert me on articles by topic  Social Bookmarking   What's this?

Maureen R. George, MSN, RN, CS; Liza C. O'Dowd, MD; Iris Martin, RN; Kathleen O. Lindell, MSN, RN; Fay Whitney, PhD; Martha Jones; Tracey Ramondo; Lynne Walsh, RN; Jacqueline Grissinger, RN; John Hansen-Flaschen, MD; Reynold A. Panettieri, Jr, MD

Arch Intern Med. 1999;159:1710-1716.

Background  Despite improved understanding of the pathophysiology of asthma, morbidity and mortality continue to rise, with disproportionate increases occurring among urban, indigent minorities. New approaches in the management of asthma are therefore necessary to reverse these dramatic and costly trends.

Objective  To determine if patients who are admitted to the hospital with acute asthma and receive inpatient education will have improved outpatient follow-up and clinical outcome measures compared with those receiving conventional care.

Methods  Patients enrolled in the study had a primary admission diagnosis of asthma and were between ages 18 and 45 years. Exclusion criteria included comorbid disease, inability to speak English, absence of a telephone in the primary residence, or pregnancy. Seventy-seven patients admitted from the emergency department with asthma were randomized to either the inpatient educational program (IEP) or routine care (control group). Patients in the IEP received asthma education, bedside spirometry, a telephone call 24 hours after discharge, and scheduled follow-up in an outpatient asthma program within 1 week of discharge. Those individuals randomized to the routine management group received conventional inpatient asthma care and routine follow-up.

Results  The patients enrolled in the IEP had a markedly higher follow-up rate compared with outpatient appointments (60% vs 27%; P=.01) and significantly fewer emergency department visits (P=.04) and hospitalizations (P=.04) for asthma in the 6 months following IEP intervention, as compared with control patients. This represented a substantial cost savings to the managed care organization.

Conclusion  Our study suggests that an IEP in the treatment of indigent, inner-city patients hospitalized with asthma reduces the need for subsequent emergent care and improves outpatient follow-up in a cost-effective manner.

From the Departments of Medical Nursing (Mss George, Martin, Walsh, and Grissinger), Medicine, Pulmonary and Critical Care Division (Mss George and Lindell and Drs O'Dowd, Hansen-Flaschen, and Panettieri), and Social Work (Dr Whitney and Mss Jones and Ramondo), University of Pennsylvania Medical Center, Philadelphia.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 1999;159(15):1818-1819.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The impact of an educational pamphlet on knowledge and anxiety in women with preeclampsia
Sauve et al.
Obstet Med 2008;1:11-17.
ABSTRACT | FULL TEXT  

Asthma exacerbations {middle dot} 4: Prevention.
FitzGerald and Gibson
Thorax 2006;61:992-999.
ABSTRACT | FULL TEXT  

Tailored Education May Reduce Health Literacy Disparities in Asthma Self-Management
Paasche-Orlow et al.
Am. J. Respir. Crit. Care Med. 2005;172:980-986.
ABSTRACT | FULL TEXT  

Written action plans for asthma: an evidence-based review of the key components
Gibson and Powell
Thorax 2004;59:94-99.
ABSTRACT | FULL TEXT  

Asthma Intervention Program Prevents Readmissions in High Healthcare Users
Castro et al.
Am. J. Respir. Crit. Care Med. 2003;168:1095-1099.
ABSTRACT | FULL TEXT  

Effectiveness of Acute Asthma Care Among Inner-city Adults
Coyle et al.
Arch Intern Med 2003;163:1591-1596.
ABSTRACT | FULL TEXT  

Model For Community Health Nursing Care: Application To An Integrated Asthma Intervention Program
Nies et al.
The Journal of School Nursing 2002;18:74-78.
ABSTRACT | FULL TEXT  

Comparing The National Economic Burden Of Five Chronic Conditions
Druss et al.
Health Aff (Millwood) 2001;20:233-241.
ABSTRACT | FULL TEXT  

Evaluation of Two Different Educational Interventions for Adult Patients Consulting with an Acute Asthma Exacerbation
CÔTÉ et al.
Am. J. Respir. Crit. Care Med. 2001;163:1415-1419.
ABSTRACT | FULL TEXT  

A comprehensive educational programme was effective for inner city patients with asthma
Cicutto
Evid. Based Nurs. 2000;3:44-44.
FULL TEXT