Brief Interventions by Primary Care Physicians Trained in Asthma Management Improve Pediatric Asthma Care

Tools and training to improve pediatric asthma management by clinicians

With a grant from the Robert Wood Johnson Foundation (RWJF), a research team from the University of Michigan School of Public Health expanded the Physician Asthma Care Education (PACE) project, which it had developed in the 1990s. The PACE model trains primary care physicians to use a brief clinical intervention to improve pediatric asthma care.

This grant allowed PACE project staff at Michigan to evaluate the PACE training to determine its impact on pediatric asthma patients. Project staff also involved a cadre of clinicians in promoting effective care among their peers.

Key Results:

  • Project staff conducted an evaluation at 10 sites in 10 cities, with the participation of 101 primary care providers and 731 patients. Project staff initially trained some 30 "Master Trainers" to provide local PACE training; additional "train-the-trainer" sessions later made PACE training more broadly available.
  • The National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health agreed to adopt and disseminate the PACE project. A page on NHLBI's website houses all project information and materials, including a training manual, videotapes, slide presentations and participant materials.
  • Project staff disseminated more than 1,000 asthma toolkits to clinicians at conferences and meetings throughout the United States.

Key Findings: A year after the training:

  • Patients of pediatricians who had PACE training had fewer days every season when their activities were limited by asthma (14.6 days versus 20 days).
  • The number of emergency department visits dropped significantly for patients of pediatricians who participated in PACE training (falling by 0.55 visits for the PACE group, compared to a drop of 0.30 visits for the others).
  • Using the intervention during a patient office visit did not affect the amount of time that pediatricians spent with patients.

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