Other Titles

Asthma Adherence and Self-Management in Pediatrics [Title Slide]

Abstract

The purpose of this pilot project was a quality improvement initiative aimed to assess various interventions designed to enhance treatment adherence amongst pediatric patients in an understaffed, underserved, rural area. It had three goals: boost interdisciplinary understanding of asthma, promote self-management amongst pediatric patients with asthma, and reduce additional clinic and emergency department visits, as well as hospitalizations.

Asthma, a chronic condition characterized by airway inflammation, affects over four million children in the US, impacting their quality of life. The condition manifests through a series of symptoms like wheezing. Without proper management, severe asthma can cause lifelong complications in pediatric patients. Nonadherence to treatment is a significant contributor to exacerbation and uncontrolled asthma.

An asthma intervention bundle was implemented to assess its impact on the self-management of 30 patients. The bundle included appointment and medication reminders, an Asthma Control Test survey, an Asthma Action Plan, and medication reconciliation. The interdisciplinary team at the underserved pediatric pulmonary clinic received an educational session on asthma and resources to assist in implementing the bundle.

The outcome of the interdisciplinary team knowledge increased by two points from a median pre-test score of 9.0 to a post-test score of 11.0. There was a decrease in emergency department visits, extra clinic visits, and hospitalizations recorded. The Asthma Control Test survey reflected an overall enhancement of self- management and decreased in patients' symptoms.

The implications for practice showed the pilot project had an impact for each intervention on clinic operations and patient adherence to asthma management plans. The project underscored the effects of resource scarcity on the clinic. Approximately 71% of patients attended their appointments, and a mere 7% brought their medications. However, there was a decrease in emergency visits from 30% at the beginning of the project to 10% at the end of project implementation.

The Asthma Action Plan proved beneficial for patients and families. Although it was found to be time-consuming for documenting by the healthcare team, it was beneficial in the long run upon patient return visits.

Notes

References:

Janevic, M. R., Stoll, S., Wilkin, M., Song, P. X., Baptist, A., Lara, M., Ramos-Valencia, G., Bryant-Stephens, T., Persky, V., Uyeda, K., Lesch, J. K., Wang, W., & Malveaux, F. J. (2016). Pediatric Asthma Care Coordination in Underserved Communities: A Quasiexperimental Study. American journal of public health, 106(11), 2012–2018. https://doi.org/10.2105/AJPH.2016.303373

Morris, T.S., Autry, E.B., & Kuhn, R.J. (2021). The Role of Biologics in the Management of Asthma in the Pediatric Patient. Journal of Pediatric Pharmacology & Therapeutics, 26(5), 427-436. https://doi.org/10.5863/1551-6776-26.5.427

Schatz, M., Sorkness, C. A., Li, J. T., Marcus, P., Murray, J. J., Nathan, R. A., Kosinski, M., Pendergraft, T. B., & Jhingran, P. (2006). Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. The Journal of allergy and clinical immunology, 117(3), 549–556. https://doi.org/10.1016/j.jaci.2006.01.011

Sheares, B. J., Mellins, R. B., Dimango, E., Serebrisky, D., Zhang, Y., Bye, M. R., Dovey, M. E., Nachman, S., Hutchinson, V., & Evans, D. (2015). Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans? American journal of respiratory and critical care medicine, 191(12), 1374–1383. https://doi.org/10.1164/rccm.201407-1338OC

Wang, L., Timmer, S., & Rosenman, K. (2020). Assessment of a University-Based Outpatient Asthma Education Program for Children. Journal of pediatric health care: official publication of National Association of Pediatric Nurse Associates & Practitioners, 34(2), 128–135. https://doi.org/10.1016/j.pedhc.2019.09.004

Description

A quality improvement project in western United States focused on pediatric asthma patients in underserved areas. A bundle implemented improved treatment adherence and self-management. This is a project that can be utilized in underserved areas globally.

Author Details

Harroop Kaur, DNP, RN;

Nancy Goldstein, DNP, ANP-BC, CNE

Sigma Membership

Nu Beta at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Pilot/Exploratory Study

Keywords:

Pediatric Patients, Asthma Adherence, Self-care, Self-Management, Underserved Areas, Rural Areas, Global Applications

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Asthma Adherence and Self-Management in Pediatrics: A Quality Improvement Project

Seattle, Washington, USA

The purpose of this pilot project was a quality improvement initiative aimed to assess various interventions designed to enhance treatment adherence amongst pediatric patients in an understaffed, underserved, rural area. It had three goals: boost interdisciplinary understanding of asthma, promote self-management amongst pediatric patients with asthma, and reduce additional clinic and emergency department visits, as well as hospitalizations.

Asthma, a chronic condition characterized by airway inflammation, affects over four million children in the US, impacting their quality of life. The condition manifests through a series of symptoms like wheezing. Without proper management, severe asthma can cause lifelong complications in pediatric patients. Nonadherence to treatment is a significant contributor to exacerbation and uncontrolled asthma.

An asthma intervention bundle was implemented to assess its impact on the self-management of 30 patients. The bundle included appointment and medication reminders, an Asthma Control Test survey, an Asthma Action Plan, and medication reconciliation. The interdisciplinary team at the underserved pediatric pulmonary clinic received an educational session on asthma and resources to assist in implementing the bundle.

The outcome of the interdisciplinary team knowledge increased by two points from a median pre-test score of 9.0 to a post-test score of 11.0. There was a decrease in emergency department visits, extra clinic visits, and hospitalizations recorded. The Asthma Control Test survey reflected an overall enhancement of self- management and decreased in patients' symptoms.

The implications for practice showed the pilot project had an impact for each intervention on clinic operations and patient adherence to asthma management plans. The project underscored the effects of resource scarcity on the clinic. Approximately 71% of patients attended their appointments, and a mere 7% brought their medications. However, there was a decrease in emergency visits from 30% at the beginning of the project to 10% at the end of project implementation.

The Asthma Action Plan proved beneficial for patients and families. Although it was found to be time-consuming for documenting by the healthcare team, it was beneficial in the long run upon patient return visits.