Institute of General Practice, Technische Universität München, Orleansstraße 47, Munich, Germany.
Respir Care. 2013 Jul;58(7):1170-7. doi: 10.4187/respcare.01968.
The primary aim of the disease management program (DMP) for patients with asthma is to improve health outcomes and to reduce costs. Five years after its introduction in Germany, no consensus has yet been reached as to whether DMP has been effective in reaching these goals.
To evaluate the DMP for asthma in Bavaria using routinely collected subject medical records.
A longitudinal population-based study encompassing over 100,000 DMP participants between 2006 (when the program began) and 2010.
The prescription rate of oral corticosteroids dropped from 15.7% in 2006 to 13.6% in 2007, and again from 7.5% in 2008 to 5.9% in 2010 (P < .001). The proportion of subjects with asthma self-management education increased from 4.4% to 23.4% (P < .001). Utilization of an individual asthma action plan increased from 40.3% to 69.3% (P < .001). Hospitalization decreased from 2.8% to 0.7% (P < .001).
In the first 4 years of DMP there was an improvement in pharmacotherapy and patient self management. The proportion of subjects requiring hospitalization decreased. Our results suggest that the German DMP for asthma has been effective in enhancing the quality of care in regard to an improved symptom frequency, adherence to guidelines, pharmacotherapy, and hospitalization.
哮喘疾病管理计划（DMP）的主要目标是改善健康结果并降低成本。在德国推出该计划五年后，对于其是否已达到这些目标仍未达成共识。
使用常规收集的患者病历评估巴伐利亚的哮喘 DMP。
一项包含 2006 年（计划开始时）至 2010 年超过 100,000 名 DMP 参与者的纵向基于人群的研究。
口服皮质类固醇的处方率从 2006 年的 15.7%降至 2007 年的 13.6%，并从 2008 年的 7.5%再次降至 2010 年的 5.9%（P <.001）。接受哮喘自我管理教育的患者比例从 4.4%增加到 23.4%（P <.001）。个人哮喘行动计划的使用率从 40.3%增加到 69.3%（P <.001）。住院率从 2.8%降至 0.7%（P <.001）。
在 DMP 的前 4 年中，药物治疗和患者自我管理得到了改善。需要住院治疗的患者比例下降。我们的结果表明，德国的哮喘 DMP 有效地提高了护理质量，改善了症状频率、对指南的依从性、药物治疗和住院治疗。
