AHCPR Seeks Improved Respiratory Disease Care

Press Release Date: December 3, 1996

The Federal Agency for Health Care Policy and Research (AHCPR) today announced several new studies on asthma and pneumonia—respiratory diseases that affect millions of Americans and significantly contribute to health care costs and lost productivity.

The first study is a 5-year, $6.08 million randomized clinical trial to improve asthma care for children and adolescents. The prevalence of childhood asthma, a serious and costly health problem, has more than doubled since 1970. Asthma affects an estimated 4.9 million children under 18 years of age, and costs approximately $1.9 billion for treatment, according to the American Lung Association.

The disease restricts breathing, can trigger other health problems and sometimes kills affected individuals. Asthma can also cause emotional and growth problems in children, and is responsible for a significant number of lost school and work days.

AHCPR Administrator Clifton R. Gaus said, "The results of this study could lead to major improvements in the health and everyday quality of life for children affected by asthma. This should be welcome news for parents, as well as for health care providers and insurers." Dr. Gaus added that data are currently very limited on the effectiveness of asthma treatment.

Under the direction of the principal investigator, Kevin B. Weiss, M.D., of Rush Presbyterian-St. Luke's Medical Center in Chicago, the researchers will test the cost-effectiveness of practice guidelines intended to reduce asthma morbidity among children.

The research team will determine the effectiveness of an opinion-leader training program, using academic detailing principles, to increase doctors' use of guideline recommendations on anti-inflammatory medications for children on chronic bronchodilator therapy. In addition, the researchers will test a new organizational approach that managed care providers could use to deliver pediatric asthma care.

The study, to be conducted in three large health maintenance organizations in Boston, Chicago and Seattle, is one of AHCPR's large-scale projects that evaluate the effectiveness of different methods of diagnosing, treating, managing and, where applicable, preventing widespread health problems. AHCPR is providing $1.28 million for the first year and has earmarked $4.80 million to complete the study. The National Heart, Lung, and Blood Institute, which developed the guideline to be used in the study (Grant No.: HSHL08368), is contributing $800,000.

AHCPR today also announced funding for:

• Outcomes of Lower Respiratory Illness in Nursing Home Residents. (Grant No.: HS08551) Under a 3-year, $2.16 million AHCPR grant, David R. Mehr, M.D., of the University of Missouri-Columbia, will lead the first outcomes research project to determine whether residents of nursing homes who contract pneumonia can be treated in the facility as safely and effectively as in a hospital, if they are at low risk of dying from the disease. The researchers will develop and test a method doctors could use to estimate expected outcomes of nursing home residents who have pneumonia. If proven effective, the formula could help physicians more accurately identify low- and high-risk patients and reduce the number of medically unnecessary hospital admissions.
• Dissemination of Guidelines for Pneumonia Length of Stay. (Grant No.: HS08282) Michael J. Fine, M.D., University of Pittsburgh, is the principal investigator of this study, which will evaluate the impact of medical care guidelines on the length of stay of persons hospitalized for treatment of community-acquired pneumonia. AHCPR has committed $1.53 million to fund the 3-year study; the National Institute of Allergy and Infectious Disease is providing $388,858.
• Developing and Testing Asthma Quality of Care Measures. (Grant No.: HS09461) Under the direction of Yvonne C. Coyle, M.D., of the University of Texas Southwestern Medical Center in Dallas, researchers will develop and test technical measures of the quality of adult asthma care. Overall AHCPR funding for the 3-year study totals $805,710.

The Agency for Health Care Policy and Research, a part of the U.S. Public Health Service, is the lead agency charged with supporting research designed to improve the quality of health care, reduce its cost and enhance access to essential services. AHCPR's broad programs of research and technology assessment bring practical, science-based information to medical practitioners, and to consumers and other health care purchasers.

For additional information, contact AHCPR Public Affairs: Howard Holland, (301) 427-1857; Salina Prasad, (301) 427-1864.