Abstract
Background and Objectives. Asthma is a common childhood condition that has an impact on the affected children, their parents, and the community. Poor management of this condition is evident. This study evaluated a structured process for quality improvement of asthma care in children. Settings and Design. Intervention strategies included the following: (a) the dissemination of clinical practice guidelines for the care of asthma in pediatrics, (b) flow sheets in the patient chart, (c) audit feedback, and (d) academic detailing. The outcome performance measures were in the areas of history, physical assessment, documentation, clinical outcome, quality of life, prescribing, knowledge, and use of health care services. Methods. A randomized controlled study of 7 centers: 3 in the intervention group and 4 in the control group. Results. The effectiveness of academic detailing was apparent in improved patient education and patients’ knowledge of trigger factors. There was a lack of any improvement in all other performance measures that were comprehensively assessed in this study. Conclusions. Academic detailing and targeted patient education were shown to be effective. Strategies that did not demonstrate effectiveness in this setting were the single session of audit and feedback, distribution of guidelines, and distribution of chart flow sheets. A future recommendation would be to strengthen self-management and structured care.
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