The JeffCare Preceptor Model for Asthma: A Primary Care Physician Tutorial Training Model (original) (raw)
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Impact of Physician Asthma Care Education on Patient Outcomes
PEDIATRICS, 2006
OBJECTIVE. We evaluated the effectiveness of a continuing medical education program, Physician Asthma Care Education, in improving pediatricians' asthma therapeutic and communication skills and patients' health care utilization for asthma.
An Educational Intervention to Train Community Pharmacists in Providing Specialized Asthma Care
American Journal of Pharmaceutical Education, 2006
Objectives. The development, implementation, and evaluation of an educational intervention to facilitate specialized asthma care provision by community pharmacists. Design. Formative evaluation and a parallel group repeated measures design were used to test the effect of an educational intervention on pharmacist satisfaction and practice behavior as well as patient outcomes. The educational intervention was based on practitioner needs and principles of adult learning using flexible delivery formats. Assessment. In the intervention area, 15 pharmacists were trained with the educational intervention, and they provided specialized asthma care to 52 patients over 6 months, while in the control area, 12 pharmacists provided ''usual care'' to 50 patients. The intervention pharmacists were highly satisfied with the education received and rated most aspects highly. Improvements in patient clinical, humanistic, and economic outcomes in the intervention area were obtained. Conclusion. The positive results of the educational intervention demonstrate the effectiveness of an educational approach grounded in the theory that inducing behavioral changes in pharmacy practitioners results in improved patient outcomes.
Development and Evaluation of a Pharmacist-Managed Asthma Education Clinic
Hospital Pharmacy, 1999
This study evaluated pharmacist-provided education of asthma patients and determined whether such educational services led to decreased emergency department (ED) visits and hospital admissions. The study population consisted of 22 asthmatic patients referred to the educational clinic by their primary care providers. Patients attended a series of sessions on asthma and its treatment, in which pharmacists taught them about medications and their appropriate use and assisted them with metered-dose inhaler (MDI) and peak flow meter techniques. An asthma action (self-management) plan was developed for each patient. Clinical outcome measures were frequency of ED visits and hospital admissions 1 year pre- and post- education, a patient satisfaction survey, and evaluation of asthma management skills. Prior to education only 5 of 20 patients were using MDIs as prescribed, whereas, after education, 18 of 20 patients or 90% (p = 0.0015) used MDIs correctly. The pharmacist-educated patients had ...
Health Education Research, 2007
Patient education in asthma management is important; however, there is little known about the characteristics of patients receiving asthma education or how often primary care physicians provide it. The objective of the study was to identify the characteristics of patients receiving asthma education. It was a cross-sectional study using 2001 National Ambulatory Medical Care Survey data. The study included 1230 physicians providing office-based ambulatory medical care in the United States. Patients in the study (weighted n 5 11 279 952) were those diagnosed with asthma based on International Classification of Diseases, 9th Revision code receiving care from a pediatrician, internist or a family physician. Main and secondary outcome measures were asthma education ordered or provided. Multivariate analysis indicated that asthma patients receiving education were more likely to have office visits > 20 min [odds ratio (OR) 5 3.934], be seen for an acute reason (OR 5 2.268), be seen in follow-up rather than an initial visit (OR 5 1.780), live in rural rather than metropolitan areas (OR 5 1.507), have public rather than private insurance (OR 5 1.276) and be seen in privately owned practices (OR 5 1.248). Bivariate analyses indicated that patients seeing family physicians were more likely than those seeing internists or pediatricians to receive education. Patient education was not uniformly provided. Family physicians provided more asthma education than either pediatricians or internists. Future research should investigate the quality of education provided.
The effect of pharmacist education on asthma treatment plans for simulated patients
Pharmacy World & Science, 2007
Objective To determine if an educational program designed for community pharmacists to help patients self manage their asthma could improve pharmacists abilities to facilitate asthma treatment plans. Setting Hamilton and Toronto, Ontario, Canada. Method A randomized controlled trial involving volunteer community pharmacists who received either an asthma education program (AEP; intervention group) or a delayed AEP (control group). The AEP consisted of a one-day workshop and two follow-up telephone calls. Teaching methods progressed from a didactic approach to self-directed learning and role playing with simulated patients (SPs). The primary outcome was measured by SPs who conducted unannounced pharmacy visits. Main Outcomes Measures The number of appropriate (defined a priori) action plans facilitated by the pharmacist was the primary outcome. Facilitated was defined as the pharmacist recommending a specific plan, taking responsibility for telephoning the physician, or ensuring the patient would take responsibility for contacting the physician.
Physician-Pharmacist Collaborative Management of Asthma in Primary Care
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2014
OBJECTIVE To determine if asthma control improves in patients who receive physician-pharmacist collaborative management (PPCM) during visits to primary care medical offices. DESIGN Prospective pre-post study of patients who received the intervention in primary care offices for 9 months. The primary outcome was the sum of asthma-related emergency department (ED) visits and hospitalizations at 9 months before, 9 months during, and 9 months after the intervention. Events were analyzed using linear mixed-effects regression. Secondary analysis was conducted for patients with uncontrolled asthma (Asthma Control Test [ACT] less than 20). Additional secondary outcomes included the ACT, the Asthma Quality of Life Questionnaire by Marks (AQLQ-M) scores, and medication changes. INTERVENTION Pharmacists provided patients with an asthma self-management plan and education and made pharmacotherapy recommendations to physicians when appropriate. RESULTS Of 126 patients, the number of emergency department (ED) visits and/or hospitalizations decreased 30% during the intervention (p=0.052) and then returned to preenrollment levels after the intervention was discontinued (p=0.83). Secondary analysis of patients with uncontrolled asthma at baseline (ACT less than 20), showed 37 ED visits and hospitalizations before the intervention, 21 during the intervention, and 33 after the intervention was discontinued (p=0.019). ACT and AQLQ-M scores improved during the intervention (ACT mean absolute increase of 2.11, AQLQ-M mean absolute decrease of 4.86, p<0.0001) and sustained a stable effect after discontinuation of the intervention. Inhaled corticosteroid use increased during the intervention (p=0.024). CONCLUSIONS The PPCM care model reduced asthma-related ED visits and hospitalizations and improved asthma control and quality of life. However, the primary outcome was not statistically significant for all patients. There was a significant reduction in ED visits and hospitalizations during the intervention for patients with uncontrolled asthma at baseline. Our findings support the need for further studies to investigate asthma outcomes achievable with the PPCM model.
2013
Objective: To identify key solutions that facilitate the prescription of long-term asthma controller and provision of written self-management plans by physicians. Methods: One hour individualized semistructured interviews were conducted with physicians. Interviews were transcribed verbatim and analyzed independently by two trained qualitative researchers. A taxonomy of facilitators (contemplated solutions) and experienced solutions was achieved by consensus within the research team. Results: Forty-two physicians (family physicians, pediatricians, emergency physicians, pulmonologists and allergists) were interviewed. The 867 facilitators and solutions, grouped in 10 categories, addressed three physician needs: support physicians in delivering optimal care (guideline dissemination, workplace culture, physician training and experience, physician attitudes toward optimal practice, tools and resources supporting physicians’ decision making); assist patients with following recommendations (patient characteristics, experiences and attitudes; physician behaviour; and tools and resources supporting patient self-management); and offer efficient services (reorganization of care; interprofessional patient management). Suggestions pertaining to the latter two categories were most frequently cited to optimize asthma management and use of selfmanagement plans (e.g., access to self-management plans; education by allied health care professionals). The most cited suggestions to support prescribing long-term controller pertained to physician behaviour (e.g., involvement in patient education, personalization of prescriptions, feedback to patients of the benefits of long-term controller). The distribution of facilitators and solutions varied across specialties. Conclusions: Physicians proposed multiple facilitators and solutions to support optimal practice, leading to the development of a novel taxonomy. Key suggestions varied across physician specialties and behaviours sought, emphasizing the need to carefully select the most promising knowledge translation interventions.
Patient education: The key to asthma management
Home Care Provider, 1998
Key to Asthma Management n recent years, asthma management has become a hot topic in health care. More and more health care providers are realizing that properly managing this disease not only improves the quality of life for the patient but also lowers the overall cost of care. This move toward asthma management has brought forth countless innovative programs of care, many of which feature intensive, one-on-one educational sessions with patients. Contributing to this trend is the National Institutes of Mealth's National Asthma Education and Prevention Program (NAEPP), which calls patient education the cornerstone of asthma management. NAEPP's recently revised Guidehes for the Diagnosis and Management of Astbm call for patient education to begin at asthma diagnosis and to be integrated into every subsequent step of medical care. 1 Although these guidelines can be applied effectively in an institutional setting, nothing can compare with one-on-one educational sessions in the. 1". home-especially considering the impact the home environment has on asthma patients. This being the case, home care professionals, like respiratory therapists, are ideal candidates for implementing successful education programs that support asthma management.