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A Fifth Vital SIgn for a Pediatric Asthma Program

Jonathan Tan, Yale School of Epidemiology and Public Health, Health Policy, 60 College Street, P.O. Box 208034, New Haven, CT 06511, 203-789-2051, jonathan.tan@yale.edu, Elizabeth W. Holt, Environmental Health Sciences, Yale School of Epidemiology and Public Health, 60 College Street, P.O. Box 208034, New Haven, CT 06511, and Dean Hosgood, Yale University School of Epidemiology and Public Health, Environmental Health Sciences, 60 College Street, P.O. Box 208034, New Haven, CT 06511.

Treatment recommendations for acute asthma pediatric patients at the Bridgeport Community Health Clinic in Bridgeport, Connecticut, are made based upon a patient’s history as well as the clinical findings. The National Heart, Lung, and Blood Institute’s (NHLBI) guidelines for the diagnosis and treatment of asthma recommend the use of clinical spirometry testing as a best practice for the treatment of asthma in an acute care setting. In accordance with these NHLBI guidelines, the BCHC has recently begun testing the use of a clinical spirometry test as a “fifth vital sign” for the management of pediatric asthma cases. This retrospective cohort study evaluated whether physicians are more or less likely to change their recommendation for treatment when they have access to spirometry and/or peak flow measurements. The study explored the following questions: 1) How does the use of peak flow/spirometry meausurements affect the treatment plan for pediatric asthma patients in an acute care setting? 2) Are peak flow readings done by the patient at home an equally effective assessment as spirometry readings done at the clinic? Both quantitative and qualitative data were analyzed in order to answer the above questions. Methods of analysis included statistical univariate, bivariate, and multivariate analyses of the frequency distribution of variables among the patient population, including chi-square and linear regression analyses to determine relationships between variables. The findings of this study provide a model that will help the BCHC and clinics across the country to implement the most cost-effective program for pediatric asthma management.

Learning Objectives: At the conclusion of this session, the participant will be able to

Keywords: Asthma,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Approaching Asthma Through Multiple Venues

The 132nd Annual Meeting (November 6-10, 2004) of APHA