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Asthma disproportionately burdens socioeconomically disadvantaged communities and is a leading cause of health disparities. Many underserved patients receive episodic treatment for asthma that does not follow current guidelines for care. This project was designed to develop baseline knowledge of asthma management in an urban federally qualified community health center.
Methods:
Medical records for all patients with a diagnosis of asthma seen between 5/1/10 and 4/30/11 are being reviewed. Several factors being assessed are demographics, spirometry, medication use, asthma severity, and peak flow monitor education. The UPMC Total Quality Council approved the work as a Quality Improvement project.
Results:
Of 1245 patients seen between 5/1/10 and 4/30/11, 221 (17.8%) patients have an asthma diagnosis. The 221 asthma patients were predominantly female (71%) and African American (84.6%). To date, 113 of 221 (51.1%) charts of asthma patients have been reviewed. Asthma severity was recorded for 13 (11.5%) patients, marked as 1 severe and 2 poorly controlled. One hundred and one patients (89.4%) are taking medications for asthma; 69 (61.1%) use corticosteroids; 28 (24.8%) use combination corticosteroids/LABAs; and 97 (85.8%) use short acting beta agonists. Spirometry scans were documented for 4 of 13 tested patients. Nineteen patients (16.8%) visited the ER for asthma. Peak flow meter counseling was provided to 3 patients.
Conclusion:
According to the National Heart Lung and Blood Institute, the lifetime asthma prevalence in the United States is 10.5%. The health center has a prevalence (17.8%) 1.7 times that of the U.S. population, with the majority of asthma patients being African American (84.6%). Documentation of many components for appropriate asthma treatment is minimal. Pharmacists can play a unique role in improving asthma management and education at the health center, and suggestions will be given. (Expected completion of this project by April 2012.)