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Asthma MAPper: A respiratory therapist driven, algorithm guided patient education program

David R. Pepper, MD MS, Department of Family and Community Medicine, UCSF Fresno, 445 S. Cedar Ave, Fresno, CA 93702, 559 459-5705, drpepper@ucsfresno.edu, Kevin D Hamilton, RRT, Community Hospitals Asthma Education Program, 1925 E. Dakota, #120B, Fresno, CA 93710, Patti Burton, RRT, Communtiy Hospitals of Central California, Asthma Education and Management Program, 1925 E. Dakota, Fresno, CA 93710, and Davin Youngclarke, MA, Family and Community Medicine, UCSF Fresno, 445 S. Cedar Ave, Fresno, CA 93702.

This study addressed the inconsistent treatment and high morbidity associated with asthma. The study’s objective was to determine whether a series of individualized asthma management sessions utilizing graphic, structured decision-making tools, termed multiphasic algorithmic protocols (MAPs), conducted by respiratory therapists in a primary care setting would significantly reduce asthma morbidity. A two-year cohort study was conducted in a community-based asthma education and management program. A total of 2,437 asthmatic patients were referred to the program. 1,956 patients, for whom all medical records were available, were included in the study. Unplanned asthma-related visits to primary care providers, emergency room visits, hospitalizations and peak flow data were evaluated one-year pre- and post-program intervention. Following completion of the program, unplanned primary care visits for asthma decreased by 71% (n = 8,842, p < 0.001), asthma-related emergency room visits decreased by 50% (n = 545, p < 0.001), hospitalizations declined by 63% (n = 206, p < 0.05). Average daily peak flow readings increased by 20% (p < 0.001). Use of Respiratory Therapists with clinical algorithms for ashtma appears effective in reducting morbidity and may warrant additional trials.

Learning Objectives:

Keywords: Asthma, Community-Based Health Promotion

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Catching our Breath: Asthma Assessment and Intervention

The 132nd Annual Meeting (November 6-10, 2004) of APHA