An Innovative Approach to Partnership in Asthma Care

Abstract

Control of asthma symptoms is fundamental to asthma management. New asthma guidelines suggest that asthma control, for most patients, can be achieved through education aimed at improving management. This includes providing written asthma management plans from health care providers; instructions on proper inhaler use; education about early signs and symptoms of asthma, and how to respond appropriately; medication regimens that prevent misuse of medications; follow-up medical care for long-term management of asthma after any hospitalization due to asthma; and assistance with assessing and reducing exposure to environmental risk factors in patients’ home, school, and work environments. The Shared Medical Appointment (SMA) is a group appointment model that has the potential to change the management of children with asthma for the better by offering benefits to both the health care provider and the patient. The SMA for children with asthma and their caregivers is an innovative 90-minute medical appointment in which 4 to 9 patients and their parents are seen at the same time in a supportive group setting. In addition to having concerns and questions about asthma addressed, the SMA provides education on medications, monitoring symptoms, and the demonstration and distribution of devices. Supportive materials are provided and discussed and education is emphasized through open group discussion and the participation of both caregiver and child. A brief, focused medical examination is also conducted. In this study, the charts of children with asthma who attended an SMA were reviewed for specific asthma-related clinical outcomes as defined by the National Heart, Lung, and Blood Institute’s, Expert Panel Review-3 (NHLBI-EPR-3) in the 4-month period prior to attending an SMA and during the 4-month period after attending an SMA. The results showed that asthma education provided in an SMA, as compared with a usual appointment, resulted in a significant positive impact on asthma-related outcomes in meeting NHLBI-EPR-3 guidelines for asthma management.