Asthma Program Outcomes
Authors: Nancy Brown, PhD, Lisa Geller, BS, & Leigha Winters, BS
Reviewer: Kellen Glinder, MD
Last reviewed date: 5/1/13
PAMF's Asthma Management Program is a team of Certified Asthma Educators (AE-C) who provide education and training to both pediatric and adult patients, working closely with doctors to develop asthma action plans that help patients manage their asthma.
If you are using a rescue inhaler (e.g. Albuterol or Xopenex) more than twice a week or do not think you understand your asthma, please ask your doctor for a referral to the Asthma Education Program at PAMF.
Outcomes through December 31, 2012
Between January 1, 2010 and December 31, 2012 we have had 2,706 patients with asthma referred who could benefit from asthma education, of which 1,608 patients attended their first asthma visit (see Chart 1).
Chart 1. Asthma Management Program Referrals (N=2,706) and Patients Seen (N=1,608) for the first education visit, 2010-2012
Patients were referred by all different divisions of PAMF (see Chart 2). Specifically, the chart below details that the referrals came from physicians in:
- Santa Cruz (51%);
- Palo Alto (33%);
- Alameda (12%); and
- Mountain View (3%).
Chart 2. Referral sources from 2010 through 2012 by division
Many (45%) of the patients whose asthma was not under control, and were seen for at least one Asthma Education visit, are under the age of 13 (see Chart 3). In addition, 53% of all people receiving at least Asthma Education visit were under the age of 18 and 47% were adults.
Chart 3. Age of patients who have been seen for at least one Asthma Education visit 2010-2012
The Asthma Management Program has developed a registry of patients living with asthma that categorized patients by looking at the number of visits to a doctor because they are wheezing, having an asthma exacerbation and/or using their rescue inhaler often enough to be out of asthma control. Chart 4 describes the percent of patients who are at risk, out of control or who have been out of control in relation to their asthma. The chart bellows reflects that there are:
- 21% of the registry patients whose asthma appears to be out of control (based on our criteria),
- 18% of those are adults,
- 14% are at risk of being out of control; and
- 65% have been out of control, but are not currently,
- 46% of those are adults.
Chart 4. Risk categories for people in the registry (those whose asthma is not under control)
- OOC = Out of Control
- HBOOC = Has Been Out of Control
Chart 4 shows the percentage of risk for those adults and children in the registry - the study finds 46% of adults and 19% of children have been out of control of their asthma. 18% of adults and 3% are out of control of their asthma and 14% of all people were at risk.
Chart 5. Change in the number of people in Asthma Registry categories - 2011-2012
Chart 5 reflects the changes in the number of people who were out of control (OOC), at risk for being out of control, and have been out of control (HBOOC) between 2011 and 2012. It is clear that fewer of our patients are living with asthma that is out of control, fewer are at risk for being out of control, and more are now in control, after having been out of control.
Chart 6. Patients receiving asthma education needed fewer medical treatments one year later 2010-2012
The data in Chart 6 is from the 2,706 patients referred for asthma education from January 1, 2010 through December 31, 2012 across all regions of the Palo Alto Medical Foundation. Chart 6 compares the end of year data from 2010-2012 between Asthma Education Patients (blue) and patients who did not receive Asthma Education (red).
You can see that patients receiving Asthma Education had:
- Fewer nebulizer treatments,
- Fewer systemic steroid prescriptions,
- Fewer acute exacerbations, as well as
- Fewer visits for wheezing.