Adults With Asthma Experience No Increase in Asthma-related Exacerbations When Digital Communication Technology Tools Are Employed to Offset Provider Workload
Adults With Asthma Experience No Increase in Asthma-related Exacerbations When Digital Communication Technology Tools Are Employed to Offset Provider Workload
复制标题
当使用数字通信技术工具来抵消提供者的工作量时，患有哮喘的成年人与哮喘相关的病情加重并没有增加
作者：
B. Bender;N. Wagner;J. Shoup;G. Goodrich;S. Shetterly;P. Cvietusa;Courtney B. Anderson;Stanley Xu;D. Ritzwoller;C. Tacinas;D. King;M. Raebel
Supplemental Digital Content is available in the text. Background: Challenges to health care efficiency are increasingly addressed with the help of digital communication technology tools (DCTs). Objective: The objective of this study was to test whether DCT, compared with Usual Care, can reduce health care clinician burden without increasing asthma-related exacerbations among patients with asthma in a large integrated health care system. Research Design: The (Breathewell) program was a pragmatic, randomized trial at (Kaiser Permanente Colorado), where asthma nurses screen patients for poor symptom control when beta2-agonist refill requests came within 60 days of previous fill or in the absence of a controller medication fill within 4 months (beta2-agonist overfill). A total of 14,978 adults with asthma were randomized to Usual Care or 1 of 2 DCT intervention groups (Text/Phone call or Email). Subjects: Participants included adults 18 and older with an asthma diagnosis at the time of randomization and no history of chronic obstructive pulmonary disease. Measures: Primary outcome measures included asthma-related health care resource utilization (eg, asthma nurse contacts), medication use, and exacerbations. Results: A total of 1933 patients had 4337 events which met beta2-agonist overfill criteria. Of the 2874 events in the intervention arm, 1188 (41%) were resolved by DCT contact and did not require additional clinician contact. Asthma medication use and exacerbations over 12 months did not differ among the 3 groups. Conclusions: DCT tools can successfully contact adult asthma patients to screen for symptoms and facilitate intervention. The absence of differences in medication fills and health care utilization indicates that the strategic replacement of nursing interventions by digital outreach did not reduce treatment adherence or compromise health care outcomes.
严重哮喘恶化的哮喘控制测试的预测性能及其成分问题。
DOI：
10.1016/j.jaip.2016.06.025
发表时间：
2017-01
期刊：
The journal of allergy and clinical immunology. In practice
影响因子：
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作者：
Cajigal S;Wells KE;Peterson EL;Ahmedani BK;Yang JJ;Kumar R;Burchard EG;Williams LK
通讯作者：
Williams LK