| Description |
Despite the availability of national guidelines on asthma management, asthma and its' complications continue to negatively impact many children and their families. Inadequate asthma management decreases quality of life, increases pediatric morbidity and drives up the cost of health care. Pediatric asthma continues to have suboptimal control rates. Many reasons contribute to this poor control, including barriers to guideline use (by providers and staff), lack of patient and parent/caregiver education on symptom recognition, treatment and management of co-morbid conditions. The overarching aim of this project was to address these issues by the promotion of a sustainable change using asthma-specific forms and education in a pediatric primary care setting. The project objectives were: to identify and attempt to attenuate barriers to the use of evidence-based asthma guidelines in a pediatric primary care setting, to implement key elements of the National Heart, Lung & Blood Institute (2007) asthma management guidelines to newly diagnosed and existing asthmatic patients ages 0-11, and to disseminate findings of the project knowledge at a professional pediatric conference. Practice integration involved barrier assessment and attempted mitigation; as well as subsequent asthma education delivery and the use of asthma-specific visit forms. Specific education pieces were developed or selected. The chosen educational pieces included the Childhood Asthma Control Test (C-ACT), personalized asthma action plans, asthma symptom recognition, AsthmaMD peak flow meter use (where age-appropriate), and information regarding AsthmaMD mobile technology. Additional items included education regarding medication and spacer use, trigger identification, environmental control measures, and an emphasis on appropriate follow-up. In summary, the project was an opportunity to effect positive change in pediatric health using the vehicle of education and staff involvement in a pediatric primary care setting. While time constraints, low sample number and lack of guideline awareness were significant barriers to the project, several conclusions surfaced. First, staff awareness of asthma management guidelines increased. Second, improvement was noted in documentation of care provided to asthmatic patients ages 0-11. Third, the project education was well received by the parents to whom the education was delivered. Suggested solutions for time constraints include an increase in the number of staff, longer appointment times for initial asthma education, appropriate billing and continued customization of materials to meet the needs of the practice. Additional recommendations include ongoing education pertaining to evidence-based asthma guidelines, promotion of mobile technology, such as the AsthmaMD application and expansion of the project to patients up to age 18. |
