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Group Visits for Asthma Slash Hospitalizations


 

WASHINGTON — Group drop-in appointments reduce emergency department visits and rescue medicine use in adult patients with asthma, according to the results of a small study.

ED and hospital use was reduced 40%, and the average use of rescue medication decreased by half over a 4-year period among patients seen as part of a weekly drop-in group, Dr. Myron Liebhaber reported in a poster at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

In addition, nocturnal waking was reduced from 4 to 1.5 times per month.

The drop-in group medical appointments were provided for adult patients with chronic asthma, who were encouraged to attend group discussions, wrote Dr. Liebhaber, an allergist in Santa Barbara, Calif. The program was designed to allow physicians to evaluate patients with asthma on a weekly basis and to provide patients with asthma education.

Groups were limited to 10 patients, and the appointments typically lasted for 90 minutes. The appointment process proceeded in three steps: vital signs and spirometry (with a nurse), an interim brief history and a physical exam (with a physician), and a group session (with an asthma educator and a behaviorist).

The study included 64 adults, who were followed for 4 years. Patients performed spirometry and completed an analog scale to measure compliance and satisfaction with care. An Asthma Control Test was also administered at each visit; results were discussed by the group to address concerns. In all, 42 patients continued the program for 4 years and were considered regular attendees.

The Asthma Quality of Life Questionnaire (AQLQ) was used to assess patients' perceptions of disease before the first visit and at 1 year later. The AQLQ assesses perceptions of activity limitation, symptoms, emotional function, and environmental exposure. Twenty-six patients completed the baseline and 1-year AQLQ; scores improved by 373 points in the first year, with the best improvement seen in the symptoms domain.

Dr. Liebhaber reported having no relevant financial relationships.

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