PHILADELPHIA — A new Internet-based initiative will soon give specialty and primary care physicians an electronic tool to ensure patients' asthma management follows revised national guidelines.
A team of physicians assembled by the American Academy of Allergy, Asthma, and Immunology (AAAAI) designed the Asthma Specialist Tool to Help Manage Asthma and Improve Quality (ASTHMA IQ), which can be found at www.asthmaiq.org
The group created the online program in response to an appeal by the National Heart, Lung, and Blood Institute to improve physician and patient compliance with the asthma diagnosis and management guidelines of the National Asthma Education and Prevention Program (NAEPP). The third edition of these guidelines was released last November (J. Allergy Clin. Immunol. 2007;120:S94–138).
The NAEPP guidelines “are very complicated, and personalizing them for patients is sometimes not easy,” said Dr. William W. Busse, chairman of the NAEPP guidelines committee, and professor and chairman of medicine at the University of Wisconsin, Madison. “The ASTHMA IQ program allows you to do this quickly, says why you do it, and, most importantly, says what to do for follow-up.”
As of mid-March, the Web-based program was available only to members of the AAAAI. But it also plans to create modified versions of the program for primary care physicians who care for asthma patients, including pediatricians and family practice physicians, said Dr. Thomas B. Casale, AAAAI president, in a press briefing during the academy's annual meeting.
“ASTHMA IQ will help clinicians implement the guidelines. It helps guide a physician to the right assessment and level of control for a patient, and it explains why a patient should be at a certain level of control,” said Dr. Casale, professor of medicine and chief of allergy and immunology at Creighton University, Omaha, Neb.
“The asthma treatment guidelines only help if they're implemented. We hope that ASTHMA IQ will help with practical implementation in physicians' offices,” said Dr. Michael Schatz, a member of the NAEPP committee, cochair of the task force that developed ASTHMA IQ, and chief of allergy at Kaiser Permanente Medical Center in San Diego. “Right now, ASTHMA IQ is a tool for asthma specialists, allergists, and pulmonologists; but there is interest in adapting a similar tool for the primary care setting.”
The AAAAI physicians who developed ASTHMA IQ plan to work with pediatrics and family practice societies to produce versions of the program that are appropriate for use by non-asthma specialists. The AAAAI decided to make ASTHMA IQ available to all physicians without charge, Dr. Casale said at the press briefing. This will be possible once modified versions are created.
When a physician first enters a patient into the ASTHMA IQ program, information is recorded on a range of clinical parameters, including the patient's asthma type, allergies, symptoms, family history, comorbidities, laboratory results, and lung function. These data are used by the program to assess the patient's asthma severity and recommend a course of treatment based on the current NAEPP guidelines.
When patients return for follow-up examinations, updated clinical data are entered, as well as information on symptom types and frequency, medication adverse effects, and treatment compliance. The program determines the degree of asthma control that has been achieved for the patient, and recommends changes in treatment.
Study results show that, at best, about 50% of American asthma patients have asthma that is well controlled. Measured by more rigorous criteria, however, the rate is closer to zero, said Dr. Schatz.
The AAAAI developed ASTHMA IQ using educational grants from Genentech Inc. and Novartis.