Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: New York (cont’d)
Superior Clinical Outcomes of Inner City Asthma Patients Treated in an Allergy Clinic
Long Island College Hospital
Bernard A. Silverman, MD
Asthma morbidity and mortality continue to increase especially in the inner cities despite medical advances in disease management. The objective of this study was to investigate the clinical outcomes of inner city asthma patients treated in an allergy and asthma clinic in Brooklyn, NY.
Phase 1 involved random review of medical records of 100 asthma patients treated in an allergy clinic for two consecutive years, assessing the frequency of hospitalizations, emergency room visits and asthma severity during three periods; one year prior to initial visit (year 0) and during the first (year one) and second (year two) years of intervention. Phase 2 involved administration of a quality of life survey to 23 patients volunteered from the allergy clinic (group I), and 21 patients volunteered from the emergency room (group II), treated by primary care or emergency room physicians during the previous year.
Study subjects attended clinic visits every 1-8weeks. During the clinic visits subjects received education and instruction on peak flow meter use and home monitoring, metered-dose inhaler and spacer proper use, medication dosages, environmental control measures, and immunotherapy when indicated.
The frequency of hospitalizations and emergency room visits significantly declined in compliers and non-compliers over time (P < .001) with greatest declines during year one. Disease severity of all patients significantly declined over time (P < .001); good compliers had significant improvement over poor compliers (P < .023). Quality of life scores were significantly lower for both groups than for the general population; and although the scores were higher in the allergy clinic group than in the non-allergy clinic group, significant differences were achieved only in mental health and social functioning domains.
The authors concluded that patients treated in an allergy clinic demonstrate superior clinical outcomes.
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