Outcome results of a school-based screening program for undertreated asthma
Authors: Yawn, Barbara P.1; Wollan, Peter1; Scanlon, Paul D.2; Kurland, Margary1
Source: Annals of Allergy, Asthma and Immunology, Volume 90, Number 5, May 2003 , pp. 508-515(8)
Publisher: American College of Allergy, Asthma, & Immunology
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Abstract:
Background: Undertreatment of asthma is associated with significant potentially preventable morbidity, including frequent school absences. Guideline dissemination and clinician education have met with variable success. School-based identification of children with potentially undertreated asthma may provide an alternative strategy for improving asthma management in children. Objective: To evaluate the effectiveness of school-based identification of potentially undertreated asthma. Methods: A controlled trial of school-based identification of children with known but symptomatic asthma using mailed parent surveys, letters recommending medical follow-up, and medical record review to evaluate changes in asthma treatment after referral. Results: Most parents (79.9%, n = 5,116 respondents) responded to the survey and 19.4% (n = 994) of children were reported to have a physician diagnosis of asthma or reactive airway disease. Letters of referral were sent to 489 children with parent-reported asthma who were identified as having potentially undertreated asthma. Approximately one-third (31.2%, n = 153) of these children had physician visits, and 92 (18.8% of all referred) had documented medication changes. In addition, there were 20 new physician diagnoses in this group of children. In the control group of 604 children with asthma, there were significantly fewer children with asthma-related visits (131, 21.7%,P = 0.0004) and children with medication changes (74, 12.3%, P = 0.002) in a comparable 6-month window. Conclusions: School-based screening or case identification increased the number of physician asthma-related visits and changes in asthma therapy.Document Type: Research article
Affiliations: 1: Department of Research, Olmsted Medical Center, Rochester, Minnesota. 2: Department Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
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