Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Michigan (cont'd)
PACE: Impact of Education for Physicians on Patient Outcomes
University of Michigan
Ann Arbor, MI
Molly Gong, MD
"PACE: Impact of Education for Physicians on Patient Outcomes" was conducted by the University of Michigan to assess the impact of an interactive seminar based on self-regulation theory on 1) treatment practices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction with care of the subjects' parents.
A total of 74 general practice pediatricians were assigned to either a program or a control group in a randomized controlled study. Data were collected from physicians at baseline, and 69 provided follow-up data 5 months after the program. Data were also collected from 637 of their patients at baseline, and in 22-month window after the intervention, 472 of this number provided follow-up data.
After the seminar, physicians in the program group were more likely than were control group physicians to address patients' fears about medicines, review written instructions, provide a sequence of educational messages, write down how to adjust the medicines at home when symptoms change, and report that they spent less time with their patients. Parents of the children treated by program physicians were significantly more likely than were control group parents to report that the physician had been reassuring, described as a goal that the child be fully active, and gave information to relive specific worries. These parents were also more likely to report that they knew how to make management decisions at home. Patients of physicians in the program group were more likely to have received a prescription for inhaled anti-inflammatory medicine and to have been asked by the physician to demonstrate how to use a metered-dose inhaler. Children seen by program physicians made significantly fewer non-emergency office visits and visits for follow-up of an episode of symptoms. Among children placed on inhaled corticosteroids during this study, children treated by physicians who had received education had significantly fewer symptoms and fewer follow-up office visits, non-emergency physician office visits, emergency department visits, and hospitalizations.
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