Abstract
BACKGROUND: A population-based, ecological evaluation was conducted to determine the impact of a regional asthma education centre on reducing asthma-related morbidity and improving the quality of prescribing.METHODS: The number of emergency department (ED) visits for respiratory-related illness and the prescribing of antiasthmatic medications were monitored during consecutive 18-month pre- and postintervention periods in two communities with similar health care resources. Using defined daily doses, the quality of prescribing was assessed by calculating the ratio of inhaled corticosteroids to inhaled, short-acting beta2-agonists.RESULTS: The reduction in the rate of respiratory-related ED visits in subjects five to 45 years of age was 410 per 10,000 people and 450 per 10,000 people for the intervention and nonintervention communities, respectively. A significant reduction in the rate of ED visits of 698 per 10,000 people was found for patients aged 35 to 45 years in the intervention community (P<0.05). The reduction achieved statistical significance in the nonintervention community in younger patients: 557 per 10,000 people and 567 per 10,000 people for patients aged five to 14 years and 15 to 24 years, respectively (P<0.05). The ratio of inhaled corticosteroids to inhaled beta2- agonists increased from 0.47 to 0.78 in the intervention community -- a 66% change. However, over the course of the preintervention period, the prescribing ratio was already increasing in this community. The corresponding ratios were 0.47 and 0.53 in the nonintervention community -- an increase of 13%.CONCLUSIONS: A conclusive association between the establishment of an asthma education centre and changes in health care use or the quality of prescribing could not be demonstrated.