Impact of obesity in asthma: evidence from a large prospective disease management study.

Background: asthma and obesity continue to have a significant effect on public health. It is widely accepted that obesity may be an independent risk factor for asthma and affect asthma severity and quality of life (QOL).

Objective: to examine the relationship between body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]) and asthma severity, spirometry findings, health care utilization (HCU), and QOL.

Long-term cost-effectiveness of disease management in systolic heart failure.

Background: Although congestive heart failure (CHF) is a primary target for disease management programs, previous studies have generated mixed results regarding the effectiveness and cost savings of disease management when applied to CHF.

Objective: We estimated the long-term impact of systolic heart failure disease management from the results of an 18-month clinical trial.

Methods: We used data generated from the trial (starting population distributions, resource utilization, mortality rates, and transition probabilities) in a Markov model to project results of continuing the disease management program for the patients' lifetimes.

Assessing the value of disease management: impact of 2 disease management strategies in an underserved asthma population.

Background: The goal of disease management (DM) is to improve health outcomes and reduce cost through decreasing health care utilization. Although some studies have shown that DM improves asthma outcomes, these interventions have not been examined in a large randomized controlled trial.

Objective: To compare the effectiveness of 2 previously successful DM programs with that of traditional care.

Cost-effectiveness of telephonic disease management in heart failure.

Objective: To evaluate the cost-effectiveness of a telephonic disease management (DM) intervention in heart failure (HF).

Study Design: Randomized controlled trial of telephonic DM among 1069 community-dwelling patients with systolic HF (SHF) and diastolic HF performed between 1999 and 2003. The enrollment period was 18 months per subject.

Cumulative recruitment experience in two large single-center randomized, controlled clinical trials.

Background: Trial recruitment is challenging for researchers, who frequently overestimate the pool of qualified, willing participants. Little has been written about recruitment and the comparative success of recruitment strategies. We describe one center's experience with recruitment in two regional single-center clinical trials with a combined total of 1971 participants.

Quantifying asthma symptoms in adults: the Lara Asthma Symptom Scale.

Background: Accurate assessment of asthma symptoms is critical in research and clinical settings. A multidimensional asthma control questionnaire could provide more accurate information about asthma symptoms than global assessments, which often overestimate asthma control.

Objective: We sought to evaluate the efficacy of the Lara Asthma Symptom Scale (LASS) in adults with persistent asthma.

Impact of home environment characteristics on asthma quality of life and symptom scores.

We explore the relationship between home-based triggers, asthma symptoms, and quality of life (QOL) with data from 177 adult and pediatric participants who received a home environmental assessment. Outcomes included the Asthma Quality of life Questionnaire, the Prediatric Asthma Quality of Life Questionnaire, the Paediatric Asthma Caregiver's Quality of Questionnaires and the Lara Asthma Symptom Scale. The absence of roaches and the use of dust mite covers were positively associated with QOL in pediatric and adult participants.

Educational attainment has a limited impact on disease management outcomes in heart failure.

The objective of this study was to assess whether educational attainment moderates outcomes in the intervention group in a trial of disease management in heart failure (HF). Data were collected from a sample of 654 patients enrolled in the disease management arm of a community- based study of HF patients. The full sample was used to analyze two primary outcomes- all-cause mortality and cardiac event-free survival.

Disease management produces limited quality-of-life improvements in patients with congestive heart failure: evidence from a randomized trial in community-dwelling patients.

Background: Disease management programs are reported to improve clinical and quality-of-life outcomes while simultaneously lowering healthcare costs.

Objective: To examine the effectiveness of disease management in improving health-related quality of life (HRQL) among patients with heart failure beyond 12 months.

Methods: A total of 1069 community-dwelling patients 18 years and older in South Texas with echocardiographic evidence of congestive heart failure were randomly assigned to disease management, augmented disease management, and control groups.

Using models and data to support optimization of the Military Health System: a case study in an intensive care unit.

Optimizing healthcare delivery--improving processes to reduce impediments to care--is an important goal of the Military Health System. Models and data can be effective tools to assist managers in achieving this goal. This paper illustrates this utility with a case study of the intensive care unit (ICU) at the US Air Force's Wilford Hall Medical Center.