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Asthma management is key to controlling symptoms, cost of treatment (1-14-00)

Asthma is increasing at an alarming rate. According to figures from the U.S. Centers for Disease Control and Prevention and the American Lung Association, 17 million people in this country suffer from the disease and several thousand die each year. It has a huge economic cost as well, measured in hospital stays, emergency room visits, doctor visits and missed workdays. There is no cure for asthma, but it can be controlled, provided that patients are taught an effective management plan.

Researchers in the Department of Respiratory Care, The University of Texas Health Science Center at San Antonio, are conducting a study to measure the effects of management plans taught by respiratory therapists in the patientsí homes. Department Chairman David C. Shelledy, Ph.D., RRT, and colleagues expect to see a reduction in the number of emergency room visits, hospitalizations and office visits, as well as improved quality of life for patients.

The randomized trial will follow three groups of patients over a six-month period following their release from the hospital. One group will receive training by a respiratory therapist, who will conduct an environmental assessment of the home, offer sessions on using equipment and medication, and give instructions for keeping a diary of symptoms. The second group will be given standard discharge instructions and make regular office visits to a physician. A third set will receive home visits from a nurse.

"We hope to get some dramatic results," Dr. Shelledy said. "People with asthma often just donít know how to take care of themselves."

A pilot study the researchers completed recently in children with asthma showed that a program of this type significantly reduces the number and cost of hospital and emergency room visits, doctor visits and school absences.

In addition to training, the respiratory therapists will develop an asthma action plan with the patients so they know what to do when their peak flow measures drop. A peak flow meter registers the amount of air a person can exhale in one breath. Each asthma patient establishes a "personal best" range. If levels drop lower than that, into pre-specified ranges, a person knows to use his inhaler, get to a doctorís office or hurry to an emergency room.

The study will last 16 to 18 months and patients are still being enrolled. For more information on the study, or the respiratory care program at the Health Science Center, call (210) 567-8850.

Contact: Will Sansom or Jennifer Lorenzo