- Email: [email protected]
Asthma camp education provides short-term health benefits
$108
Abstracts
53 Writing Wrongs?: An Evaluation of the Readability and Accuracy of Information Leaflets for People with Hay Fever H. E. Smith;, P. White 2, A. Frew3; IPrimary Medical Care, University of Southampton, Southampton, UNITED KINGDOM, 2Nightingale Surgery, Romsey, UNITED KINGDOM, 3University of Southampton, Southampton, UNITED KINGDOM. RATIONALE: Several studies have highlighted problems with the patient information leaflets (PILl relating to chronic conditions. This is the first study that has subjected information for hay fever sufferers to critical review. METHODS: Structured review of PILs, available in General Practices or Community Pharmacies, include suitability, accessibility (including readability), navigability, design and signposting. Three accredited allergists reviewed accuracy. RESULTS: Of the 38 PIL identified none were targeted at children or adolescents, 30% were published >5 years ago, all had a reading age in excess of primary level education, 80% contained inaccuracies, misinformation or a strong bias towards a single product, eg, 20% omitted to mention the utility of topical nasal corticosteroids. At the peak of the pollen season 30% pharmacies and 23% General Practices had no written information available. CONCLUSIONS: Health care professionals must read the PILs they give to hay lever sufferers to ensure the content is accurate and up to date; assess patient's reading ability and select the most appropriate material for that individual and review stocks of PIL discarding those that are out of date or inaccurate. The wholesale revision of existing PILs is impractical, but striving for lower readability in replacement leaflets and the development of more materials for children with hay fever is recommended.
Funding: Schering-PIough
154
Asthma Camp Education Provides Short-TermHealth Benefits
C. H. Song ], C. H. Pollak 2, D. Ershoff2; ]Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, 2Asthma and Allergy Foundation of America, Los Angeles. CA. RATIONALE: To study the effects of the education program offered by Asthma and Allergy Foundation (AAFA) camp in Southern California. METHODS: The campers (ages: 8-14 years) received one-hour interactive lesson for five days on various aspects of asthma. Before, 6 month and 12 months after this program, all 171 campers' adult caretakers were requested to complete a self-administered mail survey, assessing, ( I ) use and adherence with reliever and controller medications, (2) asthma-specific quality of life; (3) use of peak flow meters; (4) use of spacers; (5) understanding of written asthma action 2 plan; (6) knowledge of triggers; (7) activities to control triggers; and (8) adverse utilization tie, hospitalization and emergency room visits). RESULTS: Data obtained from the 81 campers who responded to the questionnaires at all three time points were analyzed for the above 8 parameters. At 6 months all parameters showed improvement except hospital utilization (8), but at 12 months these improvements were lost except in parameters 3, 4, and 5. CONCLUSIONS: The asthma education program offered at AAFA camp demonstrated short term benefits. To extend the benefits, asthma education needs to be reinforced after 6 months.
Funding: Self-]unded
155
Healthcare Cost Analysis of Allergic Rhinitis Treatment: Budesonide Aqueous Nasal SprayVersus Loratadine
C. Roberts;, C. Leibman 2, T. McLaughlin3; ]NDCHealth, Yardley, PA, 2AstraZeneca LP, Wilmington, DE, 3NDCHealth, Phoenix, AZ. RATIONALE: The objective of this study was to compare rhinitis-related healthcare charges before and after initial rhinitis therapy with budesonide aqueous nasal spray (BANS) or loratadine. METHODS: Patients were selected from several managed care organizations (Source: PHARMetrics Integrated Outcomes Database); those who received a new prescription for BANS or loratadine from February 2000
J ALLERGY CLIN IMMUNOL FEBRUARY 2003
to January 2001 were included in the analysis. Patients also had either an ICD-9-CM code for allergic rhinitis (477.xx) or a second prescription for the initial rhinitis medication within 6 months of the initial prescription. Patients were matched into comparable cohorts by demographic data using the propensity score method. Log-transformed allergic rhinitis charges were compared for l year after the initiation of rhinitis treatment with BANS or loratadine using ordinary least squares regression. RESULTS: There were 1,746 patients in the BANS cohort, matched with 1,746 similar patients in the loratadine group. Patients were similar in terms of age (P=.5930), sex (P=.6828), and region (P=.5318). Rhinitis-related charges in the year after treatment were $387 (SD=499) for the BANS group and $423 (SD=423) for the Ioratadine group. After adjusting for potential confounders, patients in the loratadine group incurred 17.4% greater rhinitisrelated charges in the year after treatment (13=0.174, P<.0001/. CONCLUSIONS: Patients with rhinitis treated initially with budesonide aqueous nasal spray have lower rhinitis-related healthcare charges in the year after initiation of therapy when compared with similar patients started on loratadine.
Funding: AstraZeneca LP
156 ,,.,c,.
Knowledge Base in Use of Asthma Medication Delivery Devices
J. A. Garner;, H. Nguyen 2, C. Hiatt 3, N. Olson2; JPediatrics, University of Kansas Medical Center, Kansas City, KS, 2Allergy/hnmunology, University of Kansas Medical Center, Kansas City, KS, 3University of Kansas Medical Center, Kansas City, KS. RATIONALE: Since physicians must be able to effectively teach patients proper techniques for use of asthma medication delivery devices, the knowledge base of residents and primary-care providers regarding proper administration of these devices was evaluated. METHODS: The three devices assessed included nebulizer, metereddose inhaler (MDI), and aerolizer. All devices were loaded with placebo. The fifteen study participants included thirteen residents and two primary-care providers. Participants were asked in a pre-test to demonstrate use of each device. Performance on each of several steps relating to device use was scored and timed. Participants were then taught the proper steps for device use and retested as betbre. RESULTS: For the nebulizer, there were no significant changes in performance accuracy or speed from pre- to post-instruction. For the MDI, there was a significant improvement in number of steps correctly performed (p<.001) but no change in performance time. All participants incorrectly positioned the MDI in the mouth rather than 2 cm in front of the mouth. For the aerolizer, there was a significant improvement in number of steps correctly performed (p<.007) and in pedbrmance time (p<.001). Fifty percent of participants required instruction for all steps of aerolizer use. C O N C L U S I O N S : Use of asthma medication delivery devices as an aspect of physician education is often overlooked, yet formal MDI and aerolizer training made a significant improvement in the correct use of these devices. This can have a profound impact on quality of patient care.
Funding: Self funded
157 University-Based Internal Medicine Residents' Clinic?
Are Clinical Practice Guidelines Applied to Asthmatics in a
P. F. Maloney I, J. P. Boglia 2, R. M. Mormando3; ;Department of Medicine. Division of Allergy & Immunology. SUNY at Stony Brook, Stony Brook, NY, 2Department of Medicine, SUNY at Stony Brook, Stony Brook, NY. 3Department of Medicine, SUNY at Stony Brook, Stony Brook, NY. RATIONALE: The care of the asthmatic patient is complex and time consuming. We examined whether clinical practice guidelines, as published by the 1997 National Asthma Education and Prevention Program, are adhered to in a University based Internal Medicine residents" clinic. METHODS: We selected charts by generating a list of patients seen primarily by residents, and given a billing code for the diagnosis of asthma during the period 6/00 to 11/01. The reviewers did not have clinical duties in the clinic. To ensure confidentiality, no identifying patient information was collected.
Abstracts
53 Writing Wrongs?: An Evaluation of the Readability and Accuracy of Information Leaflets for People with Hay Fever H. E. Smith;, P. White 2, A. Frew3; IPrimary Medical Care, University of Southampton, Southampton, UNITED KINGDOM, 2Nightingale Surgery, Romsey, UNITED KINGDOM, 3University of Southampton, Southampton, UNITED KINGDOM. RATIONALE: Several studies have highlighted problems with the patient information leaflets (PILl relating to chronic conditions. This is the first study that has subjected information for hay fever sufferers to critical review. METHODS: Structured review of PILs, available in General Practices or Community Pharmacies, include suitability, accessibility (including readability), navigability, design and signposting. Three accredited allergists reviewed accuracy. RESULTS: Of the 38 PIL identified none were targeted at children or adolescents, 30% were published >5 years ago, all had a reading age in excess of primary level education, 80% contained inaccuracies, misinformation or a strong bias towards a single product, eg, 20% omitted to mention the utility of topical nasal corticosteroids. At the peak of the pollen season 30% pharmacies and 23% General Practices had no written information available. CONCLUSIONS: Health care professionals must read the PILs they give to hay lever sufferers to ensure the content is accurate and up to date; assess patient's reading ability and select the most appropriate material for that individual and review stocks of PIL discarding those that are out of date or inaccurate. The wholesale revision of existing PILs is impractical, but striving for lower readability in replacement leaflets and the development of more materials for children with hay fever is recommended.
Funding: Schering-PIough
154
Asthma Camp Education Provides Short-TermHealth Benefits
C. H. Song ], C. H. Pollak 2, D. Ershoff2; ]Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, 2Asthma and Allergy Foundation of America, Los Angeles. CA. RATIONALE: To study the effects of the education program offered by Asthma and Allergy Foundation (AAFA) camp in Southern California. METHODS: The campers (ages: 8-14 years) received one-hour interactive lesson for five days on various aspects of asthma. Before, 6 month and 12 months after this program, all 171 campers' adult caretakers were requested to complete a self-administered mail survey, assessing, ( I ) use and adherence with reliever and controller medications, (2) asthma-specific quality of life; (3) use of peak flow meters; (4) use of spacers; (5) understanding of written asthma action 2 plan; (6) knowledge of triggers; (7) activities to control triggers; and (8) adverse utilization tie, hospitalization and emergency room visits). RESULTS: Data obtained from the 81 campers who responded to the questionnaires at all three time points were analyzed for the above 8 parameters. At 6 months all parameters showed improvement except hospital utilization (8), but at 12 months these improvements were lost except in parameters 3, 4, and 5. CONCLUSIONS: The asthma education program offered at AAFA camp demonstrated short term benefits. To extend the benefits, asthma education needs to be reinforced after 6 months.
Funding: Self-]unded
155
Healthcare Cost Analysis of Allergic Rhinitis Treatment: Budesonide Aqueous Nasal SprayVersus Loratadine
C. Roberts;, C. Leibman 2, T. McLaughlin3; ]NDCHealth, Yardley, PA, 2AstraZeneca LP, Wilmington, DE, 3NDCHealth, Phoenix, AZ. RATIONALE: The objective of this study was to compare rhinitis-related healthcare charges before and after initial rhinitis therapy with budesonide aqueous nasal spray (BANS) or loratadine. METHODS: Patients were selected from several managed care organizations (Source: PHARMetrics Integrated Outcomes Database); those who received a new prescription for BANS or loratadine from February 2000
J ALLERGY CLIN IMMUNOL FEBRUARY 2003
to January 2001 were included in the analysis. Patients also had either an ICD-9-CM code for allergic rhinitis (477.xx) or a second prescription for the initial rhinitis medication within 6 months of the initial prescription. Patients were matched into comparable cohorts by demographic data using the propensity score method. Log-transformed allergic rhinitis charges were compared for l year after the initiation of rhinitis treatment with BANS or loratadine using ordinary least squares regression. RESULTS: There were 1,746 patients in the BANS cohort, matched with 1,746 similar patients in the loratadine group. Patients were similar in terms of age (P=.5930), sex (P=.6828), and region (P=.5318). Rhinitis-related charges in the year after treatment were $387 (SD=499) for the BANS group and $423 (SD=423) for the Ioratadine group. After adjusting for potential confounders, patients in the loratadine group incurred 17.4% greater rhinitisrelated charges in the year after treatment (13=0.174, P<.0001/. CONCLUSIONS: Patients with rhinitis treated initially with budesonide aqueous nasal spray have lower rhinitis-related healthcare charges in the year after initiation of therapy when compared with similar patients started on loratadine.
Funding: AstraZeneca LP
156 ,,.,c,.
Knowledge Base in Use of Asthma Medication Delivery Devices
J. A. Garner;, H. Nguyen 2, C. Hiatt 3, N. Olson2; JPediatrics, University of Kansas Medical Center, Kansas City, KS, 2Allergy/hnmunology, University of Kansas Medical Center, Kansas City, KS, 3University of Kansas Medical Center, Kansas City, KS. RATIONALE: Since physicians must be able to effectively teach patients proper techniques for use of asthma medication delivery devices, the knowledge base of residents and primary-care providers regarding proper administration of these devices was evaluated. METHODS: The three devices assessed included nebulizer, metereddose inhaler (MDI), and aerolizer. All devices were loaded with placebo. The fifteen study participants included thirteen residents and two primary-care providers. Participants were asked in a pre-test to demonstrate use of each device. Performance on each of several steps relating to device use was scored and timed. Participants were then taught the proper steps for device use and retested as betbre. RESULTS: For the nebulizer, there were no significant changes in performance accuracy or speed from pre- to post-instruction. For the MDI, there was a significant improvement in number of steps correctly performed (p<.001) but no change in performance time. All participants incorrectly positioned the MDI in the mouth rather than 2 cm in front of the mouth. For the aerolizer, there was a significant improvement in number of steps correctly performed (p<.007) and in pedbrmance time (p<.001). Fifty percent of participants required instruction for all steps of aerolizer use. C O N C L U S I O N S : Use of asthma medication delivery devices as an aspect of physician education is often overlooked, yet formal MDI and aerolizer training made a significant improvement in the correct use of these devices. This can have a profound impact on quality of patient care.
Funding: Self funded
157 University-Based Internal Medicine Residents' Clinic?
Are Clinical Practice Guidelines Applied to Asthmatics in a
P. F. Maloney I, J. P. Boglia 2, R. M. Mormando3; ;Department of Medicine. Division of Allergy & Immunology. SUNY at Stony Brook, Stony Brook, NY, 2Department of Medicine, SUNY at Stony Brook, Stony Brook, NY. 3Department of Medicine, SUNY at Stony Brook, Stony Brook, NY. RATIONALE: The care of the asthmatic patient is complex and time consuming. We examined whether clinical practice guidelines, as published by the 1997 National Asthma Education and Prevention Program, are adhered to in a University based Internal Medicine residents" clinic. METHODS: We selected charts by generating a list of patients seen primarily by residents, and given a billing code for the diagnosis of asthma during the period 6/00 to 11/01. The reviewers did not have clinical duties in the clinic. To ensure confidentiality, no identifying patient information was collected.