[Efficacy of a disease management programme in asthma].

Petro W, Schulenburg J M V D, Greiner W, Weithase J, Schülke A, Metzdorf N

Klinik Bad Reichenhall, Salzburger Str. 8-11, 83435 Bad Reichenhall.

Pneumologie. 2005 Feb;59(2):101-7. doi: 10.1055/s-2004-830137.

BACKGROUND

Disease Management Programmes (DMP) are intended to improve the quality of the medical care of chronically sick patients and at the same time to keep stable or to reduce the costs to the healthcare system. The effectiveness of a DMP was evaluated by means of an accompanying study.

METHOD

Within the framework of the DMP, the patients were managed by case managers who carried out patient instructions, evaluated the symptoms and lung function values (FEV (1)) on a daily basis and supervised treatment goals with the aid of predetermined algorithms. Initially, in collaboration with the family doctor, a treatment schedule was drawn up continuously monitored and adapted. In a 12-month multicentre evaluation study, the quality of life of the patients was determined using the FLA and Euroquol questionnaires. Furthermore, symptoms, lung function (FEV (1)) and the total costs of the treatment were measured.

RESULTS

The quality of life (FLA, EuroQuol) of the patients in the Disease Management group was statistically significantly improved compared with the start of the study and with the control group. Inpatient respiratory-related costs were only incurred in the control group ( 320). No significant differences were found in the case of the other direct cost parameters (costs for asthma-related drugs 716 and 720 in the control group and DMP group respectively). The indirect costs were higher in the DMP group due to more frequent disability. With regard to overall symptoms, a pronounced reduction was only achieved in the DMP group. The mean FEV (1) measured in the physicians practice rose in the DMP group from 1.82 l to 1.89 l, whereas in the control group it fell slightly from 1.84 l to 1.78 l. The daily FEV (1) measurements at patient's home showed an increase of about 10 % in the values after 12 months.

CONCLUSIONS

The tested DMP for asthmatics brought about a significant improvement in the state of health, asthmatic symptoms and lung function of asthmatics. The direct costs of treatment were also found to be lower.