Effect of practitioner education on adherence to asthma treatment guidelines

Ann Pharmacother. Jul-Aug 2003;37(7-8):956-61. doi: 10.1345/aph.1C506.


Objective: To determine whether a letter-based intervention program submitted to prescribers and pharmacists would improve drug therapy in users of high-dose beta(2)-agonists (HDBs).

Study design: Retrospective drug utilization review.

Patients and methods: The intervention group consisted of 135 asthmatic patients (identified through ICD-9-CM codes) in the Connecticut Medicaid Program who submitted >1 claim per month for short-acting beta(2)-agonists (over a 6-mo period). Patient-specific intervention packets were mailed to the patients' prescribers and pharmacists, and their use of long-term control agents and healthcare utilization was evaluated over 6 months. These variables were compared with a comparison group (n = 510) of asthmatics drawn from the same Medicaid program who were not considered to be high-dose users of short-acting beta(2)-agonists at baseline.

Results: Prior to the intervention, the intervention group used fewer long-term asthma control agents as compared with the comparison group (58% vs. 96%; p < 0.001); there was no significant difference after the intervention program (65% vs. 71%; p = 0.169). The acquisition of spacers was greater in the intervention group than in the control group after the intervention (7% vs. 2%; p = 0.007). At the end of the 6-month intervention period, 46% of patients in the intervention group were no longer HDB users (p < 0.001). The higher frequency of prescriber office visits in the intervention group than the comparison group before the intervention (0.46 +/- 0.82 vs. 0.25 +/- 0.66; p < 0.001) was not evident after the intervention program (0.24 +/- 0.63 vs. 0.18 +/- 0.60; p = 0.283).

Conclusions: This intervention program had modest impact on improving the use of long-term control agents and reducing prescriber office visits.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-2 Receptor Agonists
  • Adrenergic beta-Agonists / therapeutic use
  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Drug Prescriptions
  • Drug Utilization Review*
  • Education, Medical*
  • Female
  • Humans
  • Male
  • Medicaid
  • Middle Aged
  • Pharmacists
  • Retrospective Studies


  • Adrenergic beta-2 Receptor Agonists
  • Adrenergic beta-Agonists
  • Anti-Asthmatic Agents