Asthma continues to be one of the most prevalent chronic lung diseases and growing health concerns in the state of Texas. Asthma, a potentially deadly illness, affects the lungs and causes the airways to become inflamed and swollen, and surrounding muscles to tighten. Symptoms include episodes of coughing, chest tightness, wheezing and shortness of breath.
According to the Texas Behavioral Risk Factor Surveillance System in 2005, an estimated 1.5 million (6.8 percent) adult Texans and 458 thousand (7.3 percent) children 0-17 years of age currently report having asthma. Also, an estimated 2.5 million (11.1 percent) adult Texans and 728 thousand (11.6 percent) children report having had asthma during their lifetime.
In addition, asthma has had a significant economic impact on the state of Texas. According to the Texas Health Care Information Collection in 2004, hospital discharges listing asthma as the principle diagnosis and other diagnoses account for about $353 million in total charges.
The Texas Asthma Plan serves as a planning tool to initiate asthma activities in the state of Texas. The 2007-2010 Edition contains issue items with updated goals and action steps specific to regional areas throughout Texas.
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Monitoring asthma in children.
Eur Respir J. 2015 Apr;45(4):906-25
Authors: Pijnenburg MW, Baraldi E, Brand PL, Carlsen KH, Eber E, Frischer T, Hedlin G, Kulkarni N, Lex C, Mäkelä MJ, Mantzouranis E, Moeller A, Pavord I, Piacentini G, Price D, Rottier BL, Saglani S, Sly PD, Szefler SJ, Tonia T, Turner S, Wooler E, Lødrup Carlsen KC
The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist in various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma. 22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus. This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised. Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.
PMID: 25745042 [PubMed - indexed for MEDLINE]
Planning for Action: The Impact of an Asthma Action Plan Decision Support Tool Integrated into an Electronic Health Record (EHR) at a Large Health Care System.
J Am Board Fam Med. 2015 May-Jun;28(3):382-93
Authors: Kuhn L, Reeves K, Taylor Y, Tapp H, McWilliams A, Gunter A, Cleveland J, Dulin M
INTRODUCTION: Asthma is a chronic airway disease that can be difficult to manage, resulting in poor outcomes and high costs. Asthma action plans assist patients with self-management, but provider compliance with this recommendation is limited in part because of guideline complexity. This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes.
METHODS: eAAP development occurred in 4 phases: web-based prototype creation, multidisciplinary team engagement, pilot, and system-wide dissemination. Medical record and hospital billing data compared frequencies of asthma exacerbations before and after eAAP receipt with matched controls.
RESULTS: Between December 2012 and September 2014, 5174 patients with asthma (∼10%) received eAAPs. Results showed an association between eAAP receipt and significant reductions in pediatric asthma exacerbations, including 33% lower odds of requiring oral steroids (P < .001), compared with controls. Equivalent adult measures were not statistically significant.
CONCLUSIONS: This study supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations. We show the feasibility of leveraging technology to provide guideline-based decision support through an eAAP, addressing known challenges of implementation into routine practice.
PMID: 25957371 [PubMed - indexed for MEDLINE]
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