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IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-03-29 DOI:10.1016/j.rmed.2025.108071

Torrie Staten , Ping-Hui Liu , Catalina Holt , Abdullah Alismail

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引用次数: 0

摘要

导言：哮喘影响着全球 3 亿多人，由于环境和社会因素，加利福尼亚州帝国县的发病率更高。哮喘社区联系项目（ACLP）旨在通过呼吸治疗师主导的活动，减少急诊就诊人数，加强哮喘患者的自我管理。本研究的目的是评估在加利福尼亚州帝王乡开展以 RT 为主导的社区项目的有效性：作为一项质量改进研究，ACLP 是一项以社区为基础的计划，于 2017-2020 年间通过哮喘管理计划（AMP）和哮喘健康计划（AWP）在帝国郡的当地医院和农村医疗诊所进行试点。参与者包括 233 名通过急诊室就诊确诊的哮喘患者。该计划包括基线临床服务、教育模块以及多达三次的家访，重点是哮喘教育和缓解诱发因素。数据分析采用配对 t 检验和卡方检验来评估干预前后哮喘控制测试 (ACT) 分数和急诊室就诊频率的变化：研究发现，哮喘控制情况有了明显改善，干预后六个月内，ACT 分数从 15.5 ± 3.03 显著上升至 21.33 ± 1.64（p < 0.001）。值得注意的是，完成全部三次家访与 6 个月和 12 个月的急诊就诊次数减少有明显关系（p < 0.01；p = 0.046）。在参与者中，58.4%的人至少接受了一次家访，这说明了干预措施的覆盖面和影响力：加利福尼亚州帝国县的 ACLP 是一项由呼吸治疗师主导的哮喘计划，它改善了哮喘管理，减少了急诊就诊率。该计划采用循证实践模式和 "计划-实施-检查-行动 "框架，通过跨学科方法解决环境和社会健康决定因素。结果表明，在服务不足的地区，哮喘得到了更好的控制，为在资源有限的环境中开展类似活动提供了宝贵的启示。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Effectiveness of a respiratory therapist-led, community-based asthma program in an under resourced rural border town In California

Introduction

Asthma affects over 300 million people globally, with a higher prevalence in Imperial County, California, due to environmental and social factors. The Asthma Community Linkages Project (ACLP) seeks to reduce emergency visits and enhance asthma self-management through respiratory therapist-led(RT-Led) initiatives. The purpose of this study was to evaluate the effectiveness of using RT-led community-based program in Imperial Country, CA.

Methods

Conducted as a quality improvement study, the ACLP is a community-based initiative piloted in Imperial County's local hospitals and rural health clinics through the Asthma Management Program (AMP) and Asthma Wellness Program (AWP) from 2017 to 2020. Participants included 233 patients diagnosed with asthma, identified through ED visits. The program incorporated baseline clinical services, educational modules, and up to three home visits focused on asthma education and trigger mitigation. Data analysis employed paired t-tests and chi-squared tests to assess changes in Asthma Control Test (ACT) scores and ED visit frequency pre-and post-intervention.

Results

The study observed significant improvements in asthma control, with ACT scores rising significantly from 15.5 ± 3.03 to 21.33 ± 1.64 (p < 0.001) within six months post-intervention. Notably, completing all three home visits was significantly associated with reduced ED visits at six and twelve months (p < 0.01; p = 0.046). Among the participants, 58.4 % received at least one home visit, underscoring the intervention's reach and impact.

Conclusion

The ACLP, a respiratory therapist-led asthma program in Imperial County, California, improved asthma management and reduced emergency department visits. Using an evidence-based practice model and the Plan-Do-Check-Act framework, it addressed environmental and social health determinants through an interdisciplinary approach. The results demonstrated better asthma control in underserved areas, offering valuable insights for similar initiatives in resource-limited settings.

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.