Back to Browse Journals » Journal of Asthma and Allergy » Volume 1

Introduction of Asthma APGAR tools improve asthma management in primary care practices

Authors Barbara P Yawn, Susan Bertram, Peter Wollan

Published Date August 2008 Volume 2008:1 Pages 1—10

DOI http://dx.doi.org/10.2147/JAA.S3595

Published 31 August 2008

Department of Research, Olmsted Medical Center, Rochester, MN, USA

Objective: Primary care asthma management is often not compatible with national evidence-based guidelines. The objective of this study was to assess the feasibility and impact of the Asthma APGAR tools to enhance implementation of asthma guideline-compatible management in primary care practices.

Subjects: Twenty-four primary care practices across the US.

Methods: This is a mixed methods study. Quantitative data were used to assess changes in guideline recommended asthma management including use of daily controller therapy, planned care visits, and education and information documentation before and after implementation of the Asthma APGAR. Qualitative data from focus group sessions were used to assess health care professional and patient perceived usability and value of the Asthma APGAR tools during office visits for asthma.

Results: Implementing the Asthma APGAR tools in the 24 practices was associated with enhanced asthma visit-related medical record documentation including significant increases in recording of activity limitations due to asthma and asthma symptom frequency, asthma medication nonadherence, asthma triggers, and the patients’ perceived response to therapy (p < 0.01 for each item). Some care processes also increased significantly including assessment of inhaler technique and prescribing of daily controller therapy among patients with persistent asthma. Focus groups of patients and of clinical staff reported that the Asthma APGAR tools were easy to use, “made sense” and “improved care” was given and received.

Conclusions: The Asthma APGAR tools are feasible to implement in primary care practices and their implementation is associated with increased guideline-compliant asthma management.

Keywords: asthma, guidelines, implementation, quality improvement, asthma control, mixed methods studies, qualitative research, primary care

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Other articles by this author:

Protocol for the asthma tools study: a pragmatic practice-based research network trial

Yawn BP, Bertram S, Kurland M, Wollan P, Graham D, Littlefield D, Smail C, Pace W

Pragmatic and Observational Research 2013, 4:7-18

Published Date: 4 June 2013

Exacerbations in the pre- and post-COPD diagnosis periods

Yawn BP, Wollan P, Rank M

Pragmatic and Observational Research 2013, 4:1-6

Published Date: 2 May 2013

Automated patient and medication payment method for clinical trials

Yawn BP, Madison S, Bertram S, Pace WD, Fuhlbrigge A, Israel E, Littlefield D, Kurland M, Wechsler ME

Open Access Journal of Clinical Trials 2013, 5:23-31

Published Date: 29 January 2013

Readers of this article also read:

Self-reported knowledge and awareness about blood pressure and hypertension: a cross-sectional study of a random sample of men and women aged 60–74 years

Qvist I, Thomsen MD, Lindholt JS, Ibsen H, Hendriks JML, Frost L

Clinical Epidemiology 2014, 6:81-87

Published Date: 15 February 2014

Matched case-control studies: a review of reported statistical methodology

Niven DJ, Berthiaume LR, Fick GH, Laupland KB

Clinical Epidemiology 2012, 4:99-110

Published Date: 27 April 2012

Validation of four automatic devices for self-measurement of blood pressure according to the international protocol of the European Society of Hypertension

Topouchian J, Agnoletti D, Blacher J, Youssef A, Ibanez I, Khabouth J, Khawaja S, Beaino L, Asmar R

Vascular Health and Risk Management 2011, 7:709-717

Published Date: 30 November 2011

Corrigendum

Sailasuta N, Harris K, Tran T, Ross B

Neuropsychiatric Disease and Treatment 2011, 7:707-708

Published Date: 25 November 2011

Corrigendum

Schneider EW, Johnson MW

Clinical Ophthalmology 2011, 5:1315-1316

Published Date: 16 September 2011

Survival of prostate cancer patients in central and northern Denmark, 1998–2009

Borre M, Erichsen R, Lund L, Larsen EH, Nørgaard M, Jacobsen JB

Clinical Epidemiology 2011, 3:41-46

Published Date: 21 July 2011

Having children with multiple partners is associated with reduced risk of malignant melanoma: an observation seeking a plausible explanation

Anne V Olesen, Erik T Parner, Preben B Mortensen, et al

Clinical Epidemiology 2010, 2:229-233

Published Date: 4 October 2010

Influence of demographic and metabolic variables on forearm blood flow and vascular conductance in individuals without overt heart disease

Thiago E Sartori, Rafael AB Nunes, Gisela T da Silva, et al

Vascular Health and Risk Management 2010, 6:431-437

Published Date: 31 May 2010