Multidisciplinary education and management program for children with asthma

A multidisciplinary program for managing asthma in a pediatric population i s discussed. A coordinated, multidisciplinary program for managing asthma in children wa s initiated in November 1997 at a U.S. Army medical center. The program, de signed to improve care and decrease hospitalizations for asthma, was pharma cist managed and pulmonologist directed and was implemented by pediatrician s. Patient education was provided by a pediatric clinical pharmacist or a n urse case manager; providers also received intensive education. Follow-up o ccurred at predetermined intervals and included asthma education, discussio n of expectations and goals, analysis of metered-dose-inhaler and spacer te chnique, and assessment of compliance. Between November 1997 and January 19 99, 210 inpatients were screened for asthma. One hundred seven were believe d to have asthma and received inpatient asthma counseling and teaching. Of these 107 patients, 79 were enrolled in the program and monitored in the am bulatory care setting. Seventy-one (90%) of the 79 program enrollees were n ot rehospitalized during the ensuing two years. The number of children admi tted to the hospital for asthma decreased from 147 in 1997 (a rate of 32 pe r 1000 population) to 93 in 1998 (2.1 per 1000) and to 87 in 1999 (1.9 per 1000). A multidisciplinary approach to the management of children with asthma may reduce hospitalizations of such patients.