Improving Pediatric Asthma by the MSAGR Algorithm: A Multicolored, Simplified, Asthma Guideline Reminder
Abstract
The National Asthma Education and Prevention Program (NAEPP) guidelines, considered the “gold standard” for asthma care, are still underused 17 years after their publication. This feasibility study tested the effectiveness of the Multicolored, Simplified, Asthma Guideline Reminder (MSAGR © ), an algorithm chart intervention for clinicians, in increasing adherence to the NAEPP guidelines. Pretest and posttest data were gathered to determine if there were differences in asthma outcomes for school-age children, using the patients as their own controls. The primary outcome measures included pulmonary function, measured by FEV 1 ; number of asthma exacerbations, assessed using utilization of health care services; and disease-specific quality of life, using the Child Health Survey for Asthma. The study found that the NAEPP guidelines were not being followed and some children were undertreated for asthma symptoms. The intervention was promising: 83% of providers reported the MSAGR © was helpful in classifying patients' asthma promptly, and 67% of clinicians altered the medications prescribed for half of their pediatric patients. Moreover, parents were positive: 78% reported that participating in the study helped reduce their child's asthma triggers and performing spirometry was easy for their child. This study demonstrated that the MSAGR © can improve asthma outcomes in children and is feasible for implementation in the real-world conditions that clinicians face in busy practices.