STHMA IS COMMON, AFFECTing 5% to 12% of the adult population. 1,2 In the United States alone, asthma affects more than 200 000 adults and accounted for approximately 465000 hospitalizations, 1.8 million emergency department visits, 10.4 million physician office visits, and 4487 deaths in 2000. 3 For largely unknown reasons, US women have a 30% higher prevalence and 40% more asthma attacks than men, and blacks have a 10% higher prevalence and 20% more asthma attacks than whites. 3 The prevalence of self-reported asthma has increased 74% over the past 2 decades, 2 with a doubling in the number of office visits and a 61% increase in asthma-related deaths. 2 The current total annual costs of asthma are $11 billion. 2-5 Asthma is characterized clinically by repeated episodes of wheezing, breathlessness, chest tightness, and coughing, usually in the presence of variable (and reversible) airflow obstruction. 6 Most patients also demonstrate air-Author Affiliations and Financial Disclosures are listed at the end of this article.

A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

Despite the high use of inhaled corticosteroids, the majority of children had poorly controlled asthma. The poor control group had more exposure to tobacco smoke and a worse psychosocial impact due to asthma. Few children had past asthma education and action plans, suggesting that there is a need to improve access to and tools for education.

Focus group interviews are a common approach to data collection in qualitative research projects. They are, however, a method with the potential for methodological and pragmatic difficulties, many of which stem from transcribing focus group data from an audiotape. An alternative to postinterview transcription is the use of a court reporter. Advantages found using court reporters were increased accuracy, timely receipt of transcripts, less distraction for focus group facilitators, guaranteed confidentiality, time saved reviewing transcripts, and convenience. Because court reporters do not traditionally work in health research, there might be issues with medical terminology that require diligence on the part of the researcher to ensure that jargon is appropriately identified and transcribed. Using court reporters in rural areas might be cost-prohibitive because of travel expenses. Court reporters offer a viable and worthwhile approach to data transcription, and in our experience, have provided our research team with rich and accurate data.

Barriers and enablers perceived by health care professionals and parents that influenced asthma management will inform the optimization of the PCAPP prior to its evaluation.

Our study indicates a gap in the provision of asthma education, written action plans, and spirometric testing for patients diagnosed with asthma among primary care physicians.

BackgroundAsthma is the most common chronic condition in children. For many, the disease is inadequately controlled, which can burden the lives of children and their families as well as the health care system. Improved use of the best available scientific evidence by primary care practitioners could reduce the need for hospital care and improve quality of life and asthma control, thereby reducing overall costs to society and families.ObjectiveThe Primary Care Pathway for Childhood Asthma aims to improve the management of children with asthma by (1) providing primary care practitioners with an electronic guide (a clinical pathway) incorporated into the patient’s electronic medical record, and (2) providing train-the-trainer education to chronic disease management health professionals to promote the provision of asthma education in primary care.MethodsThe research will utilize a pragmatic cluster-controlled design, quantitative and qualitative research methodologies, and economic evaluation to assess the implementation of a pathway and education intervention in primary care. The intervention will be analyzed for effectiveness, and if the results are positive, a strategy will be developed to implement delivery to all primary care practices in Alberta.ResultsThe research has been successfully funded and ethics approvals have been obtained. Practice recruitment began fall 2015, and we expect all study-related activities to be concluded by March 2018.ConclusionsThe proposed pathway and education intervention has the potential to improve pediatric asthma management in Alberta. The intervention is anticipated to result in better quality of care for equal or lesser cost.ClinicalTrialClinicalTrials.gov NCT02481037; https://clinicaltrials.gov/ct2/show/NCT02481037 (Archived by WebCite at http://www.webcitation.org/6fPIQ02Ma).

Parent's QOL perception, and not the child's, is associated with asthma management. RAP decreased the parent's QOL symptoms assessment and was important in determining the child's asthma management.