Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Georgia
Improving Asthma Outcomes in Safety Net Practices
National Center for Primary Care, Morehouse School of Medicine
Elvan Catherine Daniels, MD
Improving Asthma Outcomes in Safety Net Practices is a program begun in 2000 through the partnership of the Southeast Regional Clinicians Network and the National Center for Primary Care at Morehouse School of Medicine. The program, initially funded by the National Health Lung Blood Institute, was designed to increase compliance with national asthma care guidelines in primary care safety net health centers serving high-disparity patient populations (children and adults). The program serves federally qualified health centers in the Southern US.
Health teams consisting of a physician and a health educator spend a single half-day at selected health centers instructing the clinic staff on asthma guidelines, and tools or templates for practice-level systems change (i.e., asthma flow sheets and standing orders). Resource kits are provided to the health centers including a peak flow meter, metered-dose inhaler spacer device, and educational materials.
A group-randomized controlled trial was done to assess the effectiveness of the intervention in federally funded community health centers in eight southeastern states. There were seven intervention and nine control sites. Chart reviews were performed to determine practitioners' compliance with national guidelines for asthma care.
Clinicians practicing in intervention health centers showed significantly greater improvement in provider behavior/compliance than did the control centers. The authors note that the post-intervention compliance with guidelines was still sub-optimal.
The authors conclude that dissemination of national guidelines is not enough; providers need training and guideline-specific resources, in combination with tools for practice change.
The program is currently ongoing.
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