EVIDENCE-BASED FOCUSED APPROACH FOR FULFILLMENT OF AIMS: EXPERIENCES OF AN ASTHMA CLINIC
| Autor: | Maj Abhishek Mallick, Dakhane Yogesh, Col Rajeev Kumar Thapar, Sudhanshu Tiwari, Col Sunil Jain, Y. V. Abhijith |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pediatrics
medicine.medical_specialty Evidence-based practice business.industry Emergency department Institute of medicine Asthma clinic 030204 cardiovascular system & hematology medicine.disease Confidence interval 03 medical and health sciences 0302 clinical medicine Relative risk medicine Health education 030212 general & internal medicine business Asthma |
| Zdroj: | Indian Journal of Child Health. :170-175 |
| ISSN: | 2349-6126 2349-6118 |
| DOI: | 10.32677/ijch.2017.v04.i02.014 |
| Popis: | Background: A new health system for the 21st century should be based on the best scientific knowledge, according to the Institute of Medicine, US. Objective: We have evaluated the effectiveness of asthma clinic providing comprehensive care based on the best available scientific evidence. Materials and Methods: This intervention study was conducted in a tertiary care hospital having a devoted asthma clinic for the comprehensive management. All children diagnosed as having asthma were included, and data of cases managed from July 2014 to June 2016 were analyzed. Intervention - comprehensive management of asthma including assessment, monitoring, health education, avoidance of triggers, management of comorbid conditions, appropriate medications, written asthma action plan, and counseling for follow-up. Outcome measures were treatment direction, asthma control, emergency visits, and hospitalizations. Results: 260 children were treated over a 2-year period. The effects of focused approach with progressive expertise lead to statistically significant benefits over the two successive years from July 2014 to June 2015 and July 2015 to June 2016. These were in: (i) Treatment direction: Cases requiring stepping up of treatment decreased from 36.49% to 17.24% (relative risk [RR]: 0.473 [95% confidence interval {CI}: 0.249-0.895]); p=0.01229, (ii) asthma control: Cases with not well-controlled asthma decreased from 16.44% to 7.02% (RR 0.427: [95% CI: 0.199-0.914]); p=0.045, (iii) emergency department visits decreased from 35.62% to 21.05% (RR 0.591: [95% CI: 0.39-0.897]), p=0.00766, (iv) hospitalizations decreased from 16.44% to 5.26% (RR 0.32: [95% CI: 0.135-0.757]), p=0.00462. Conclusion: Establishing an asthma clinic and progressive expertise leads to significant beneficial results. |
| Databáze: | OpenAIRE |
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