Baseline Assessment of an Inner City Population Enrolled in an Asthma Disease Management Programme: Data for Continuous Programme Improvement

Disease management, a new treatment model that may improve outcomes for patients with chronic illness, emphasises the need for formal assessments often not included in traditional approaches to healthcare, such as environmental exposures, self-care skills and functional status. This article discusses the importance of these measures in designing a disease management programme for asthma and presents the results of a study of patients referred to this programme. The objectives of the programme were to determine: 1. baseline functional status 2. any barriers to treatment 3. home exposure to patient-reported asthma triggers; and 4. patients' self-care skills. The proportion of referred patients who actually enrolled in the programme and, among those patients, the proportion who completed the prescribed educational component and attended the scheduled follow-up visits were also calculated. The investigators developed a structured assessment battery that included standardised measures of functioning; this battery was administered by clinical and research staff at enrolment and at 3- and 6-month follow-up. The patients (n = 228) had significantly lower functioning compared with the Medical Outcomes Study general US population norms and for patients with chronic lung disease. 71% (n = 127) of patients endorsed 1 or more of the 3 items on a depression screen. 85.5% of patients completed the 3 educational sessions; 104 of 228 patients (45.6%) returned for the 6-month follow-up visit. This study contributes data about the design of disease management programmes and about asthma in inner city and minority patients, which are important topics in current research.