SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
12/30/05
Improved asthma outcomes with care by allergists
Summary
Background - Several previous studies described improved asthma outcomes in patients under allergists' care. However, such studies were relatively small and had methodologic limitations.
Findings - Schatz et al of the Kaiser-Permanente Medical Center in San Diego, CA sent questionnaire to a random sample of 3,568 asthmatic patients treated in their integrated health system. In this group, asthma care was rendered by a primary care provider (PCP) in 47%, by an allergist in 25%, by a pulmonologist in 6% and with no regular source of asthma care in 19%.
They found that care by allergists (when compared to care by PCP) was associated with significantly better quality of life (p<0.001), greater use of inhaled corticosteroids (OR=1.81) and less asthma control problems, need for asthma hospitalization (OR=0.45) or unscheduled asthma treatment visits (OR=0.71). Likely as a result of such outcomes, asthma patients treated by allergists had a higher degree of satisfaction with the care they received.
Reference
J Allergy Clin Immunol 2005;116:1307-13 Editor's Comments
The authors of this study were very careful in obtaining adequate information from a sizable percentage of asthmatic patients contacted with questionnaires while avoiding potential sampling biases. Their finding that asthma care outcomes were significantly better in those treated by allergists is not that surprising. Allergists are much more experienced with asthma care than is the average PCP. Also, allergists are generally more aware of the latest developments in asthma care as part of their CME training. This includes the importance of repeated education of the asthmatic patient, including patient participation in asthma self-management programs.
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